Evidence map›Paper›PMID 35436301›Full record

ArticlePloS one2022

The diagnostic value of nasal microbiota and clinical parameters in a multi-parametric prediction model to differentiate bacterial versus viral infections in lower respiratory tract infections.

Yunlei Li, Chantal B van Houten, Stefan A Boers, Ruud Jansen, Asi Cohen, Dan Engelhard, Robert Kraaij, Saskia D Hiltemann, Jie Ju, David Fernández and 31 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors at 11 institutions in 3 countries.

Yunlei LiDepartment of Pathology & Clinical Bioinformatics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0002-5697-1602
Chantal B van HoutenDivision of Paediatric Immunology and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Stefan A BoersDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Ruud JansenStreeklab Haarlem, Haarlem, The Netherlands.
Asi CohenMeMed, Tirat Carmel, Israel.
Dan EngelhardDivision of Paediatric Infectious Disease Unit, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel.
Robert KraaijDepartment of Internal Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Saskia D HiltemannDepartment of Pathology & Clinical Bioinformatics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Jie JuDepartment of Pathology & Clinical Bioinformatics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
David FernándezNoray Bioinformatics, Derio, Spain.
Cristian MankocNoray Bioinformatics, Derio, Spain.
Eva GonzálezNoray Bioinformatics, Derio, Spain.
Wouter J de WaalDepartment of Paediatrics, Diakonessenhuis, Utrecht, The Netherlands.
Karin M de Winter-de GrootDepartment of Paediatric Respiratory Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Tom F W WolfsDivision of Paediatric Immunology and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Pieter MeijersDepartment of Paediatrics, Gelderse Vallei Hospital, Ede, The Netherlands.
Bart LuijkDepartment of Respiratory Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Jan Jelrik OosterheertDepartment of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Sanjay U C SankatsingDepartment of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Aik W J BossinkDepartment of Respiratory Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Michal SteinDepartment of Paediatrics, Hillel Yaffe Medical Centre, Hadera, Israel.
Adi KleinDepartment of Paediatrics, Hillel Yaffe Medical Centre, Hadera, Israel.
Jalal AshkarDepartment of Paediatrics, Hillel Yaffe Medical Centre, Hadera, Israel.
Ellen BambergerMeMed, Tirat Carmel, Israel.
Isaac SrugoDepartment of Paediatrics, Bnai Zion Medical Centre, Haifa, Israel.
Majed OdehDepartment of Internal Medicine A, Bnai Zion Medical Centre, Haifa, Israel.
Yaniv DotanPulmonary Division, Rambam Health Care Campus, Haifa, Israel.
Olga BoicoMeMed, Tirat Carmel, Israel.
Liat EtshteinMeMed, Tirat Carmel, Israel.
Meital PazMeMed, Tirat Carmel, Israel.
Roy NavonMeMed, Tirat Carmel, Israel.
Tom FriedmanMeMed, Tirat Carmel, Israel.
Einav SimonMeMed, Tirat Carmel, Israel.
Tanya M GottliebMeMed, Tirat Carmel, Israel.
Ester Pri-OrMeMed, Tirat Carmel, Israel.
Gali KronenfeldMeMed, Tirat Carmel, Israel.
Kfir OvedMeMed, Tirat Carmel, Israel.ORCID 0000-0003-3611-2218
Eran EdenMeMed, Tirat Carmel, Israel.
Andrew P StubbsDepartment of Pathology & Clinical Bioinformatics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Louis J BontDivision of Paediatric Immunology and Infectious Diseases, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
John P HaysDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
MeMed (Israel) · ILErasmus MC Cancer Institute · NLUtrecht University · NLDiakonessenhuis hospital · NLHillel Yaffe Medical Center · ILNoray Bioinformatics (Spain) · ESBnai Zion Medical Center · ILHadassah Medical Center · ILRambam Health Care Campus · ILStreeklab Haarlem · NLZiekenhuis Gelderse Vallei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe ability to accurately distinguish bacterial from viral infection would help clinicians better target antimicrobial therapy during suspected lower respiratory tract infections (LRTI). Although technological developments make it feasible to rapidly generate patient-specific microbiota profiles, evidence is required to show the clinical value of using microbiota data for infection diagnosis. In this study, we investigated whether adding nasal cavity microbiota profiles to readily available clinical information could improve machine learning classifiers to distinguish bacterial from viral infection in patients with LRTI.

resultsVarious multi-parametric Random Forests classifiers were evaluated on the clinical and microbiota data of 293 LRTI patients for their prediction accuracies to differentiate bacterial from viral infection. The most predictive variable was C-reactive protein (CRP). We observed a marginal prediction improvement when 7 most prevalent nasal microbiota genera were added to the CRP model. In contrast, adding three clinical variables, absolute neutrophil count, consolidation on X-ray, and age group to the CRP model significantly improved the prediction. The best model correctly predicted 85% of the 'bacterial' patients and 82% of the 'viral' patients using 13 clinical and 3 nasal cavity microbiota genera (Staphylococcus, Moraxella, and Streptococcus).

conclusionsWe developed high-accuracy multi-parametric machine learning classifiers to differentiate bacterial from viral infections in LRTI patients of various ages. We demonstrated the predictive value of four easy-to-collect clinical variables which facilitate personalized and accurate clinical decision-making. We observed that nasal cavity microbiota correlate with the clinical variables and thus may not add significant value to diagnostic algorithms that aim to differentiate bacterial from viral infections.

Indexed as

Bacterial InfectionsMicrobiotaRespiratory Tract InfectionsVirus DiseasesC-Reactive ProteinHumansNoseC-Reactive Protein

Identifiers

PMID35436301
PMCPMC9015155
OpenAlexW4224246914

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.