Evidence map›Paper›PMID 36153766›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2022

Use of Host Response to Refine the Diagnosis of Group A Streptococcal Pharyngitis.

Jinsheng Yu, Eric Tycksen, Wei Yang, Thomas J Mariani, Soumyaroop Bhattacharya, Ann R Falsey, David J Topham, Gregory A Storch

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
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

8 authors.

Jinsheng YuDepartment of Genetics, Genome Technology Access Center at the McDonnell Genome Institute, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Eric TycksenDepartment of Genetics, Genome Technology Access Center at the McDonnell Genome Institute, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Wei YangDepartment of Genetics, Genome Technology Access Center at the McDonnell Genome Institute, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Thomas J MarianiDepartment of Pediatrics, Division of Neonatology and Pediatric Molecular and Personalized Medicine Program, University of Rochester School of Medicine, Rochester, New York 14642, USA.
Soumyaroop BhattacharyaDepartment of Pediatrics, Division of Neonatology and Pediatric Molecular and Personalized Medicine Program, University of Rochester School of Medicine, Rochester, New York 14642, USA.
Ann R FalseyDepartment of Medicine, University of Rochester School of Medicine, Rochester, New York 14642, USA.
David J TophamDepartment of Medicine, University of Rochester School of Medicine, Rochester, New York 14642, USA.
Gregory A StorchDepartment of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA.ORCID 0000-0001-5817-4159

Funding

Washington University Center for Cellular ImagingP30CA091842 · NCI · WASHINGTON UNIVERSITY · PI TIMOTHY J. EBERLEIN · 2001 to 2026
$128.0M
WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
VISUAL INDICES OF NEUROTOXICITYP30ES001247 · NIEHS · UNIVERSITY OF ROCHESTER · PI Martha Susiarjo · 1985 to 2026
$42.8M
NCATS NIH HHS UL1 TR002345NCI NIH HHS P30 CA091842NCI NIH HHS P30 CA91842NIAID NIH HHS HHSN272201200005CNIEHS NIH HHS P30 ES001247
6 · The paper itself

Abstract

backgroundCurrent diagnostic tests for pharyngitis do not distinguish between symptomatic group A Streptococcus (GAS) infection and asymptomatic colonization, resulting in over-diagnosis and unnecessary use of antibiotics. We assessed whether measures of host response could make this distinction.

methodsWe enrolled 18 children with pharyngitis having Centor scores of 4 or 5 and 21 controls without pharyngitis or other acute infections. Both groups had throat cultures, molecular tests for GAS and respiratory viruses and IgM serology for Epstein-Barr virus. Host response was evaluated with white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), and sequencing of RNA from peripheral blood leukocytes.

resultsOf 18 cases, 11 had GAS pharyngitis, 3 had adenovirus pharyngitis and 4 had other pharyngitis. Among asymptomatic controls, 5 were positive for GAS. WBC, CRP, and PCT were higher in subjects with pharyngitis compared to asymptomatic controls including those with GAS. Transcriptional profiles from children with symptomatic GAS were clearly distinct from those of children in all other groups. The levels of two genes, CD177 and TLR5 each individually accurately distinguished between symptomatic and asymptomatic GAS. Optimal diagnostic sensitivity and specificity were achieved by the combination of CRP and PCT, and by each of the two gene markers.

conclusionIn this exploratory study, we showed that traditional measures of inflammation and markers of host gene expression distinguish between symptomatic and asymptomatic GAS. These results point to future rapid molecular approaches for improving the diagnosis of GAS pharyngitis, that may help reduce unnecessary antibiotic use.

Indexed as

Epstein-Barr Virus InfectionsPharyngitisStreptococcal InfectionsAnti-Bacterial AgentsChildC-Reactive ProteinHerpesvirus 4, HumanHumansProcalcitoninStreptococcus pyogenesAnti-Bacterial AgentsC-Reactive ProteinProcalcitoninC-reactive proteinpharyngitisprocalcitoninStreptococcus pyogenestranscriptome

Identifiers

PMID36153766
PMCPMC9720373

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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.