Evidence map›Paper›PMID 39249176›Full record

ArticleInfection2025

Evaluation of a host-protein signature score for differentiating between bacterial and viral infections: real-life evidence from a German tertiary hospital.

Laura Wagner, Heike Schneider, Peter B Luppa, Kathrin Schröder, Nina Wantia, Christiane Querbach, Samuel D Jeske, Tobias Lahmer, Kathrin Rothe, Miriam Dibos and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Laura WagnerTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany. laura.wagner@mri.tum.de.ORCID https://orcid.org/0000-0002-5184-8154
Heike SchneiderTUM School of Medicine and Health, Department of Clinical Chemistry and Pathobiochemistry, University Medical Center, Technical University of Munich, Munich, Germany.
Peter B LuppaTUM School of Medicine and Health, Department of Clinical Chemistry and Pathobiochemistry, University Medical Center, Technical University of Munich, Munich, Germany.
Kathrin SchröderTUM School of Medicine and Health, Department of Medical Microbiology, Immunology and Hygiene, University Medical Center, Technical University of Munich, Munich, Germany.
Nina WantiaTUM School of Medicine and Health, Department of Medical Microbiology, Immunology and Hygiene, University Medical Center, Technical University of Munich, Munich, Germany.
Christiane QuerbachTUM School of Medicine and Health, Department of Pharmacy, University Medical Center, Technical University of Munich, Munich, Germany.
Samuel D JeskeTUM School of Medicine and Health, Department of Virology, University Medical Center, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany.
Tobias LahmerTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Kathrin RotheTUM School of Medicine and Health, Department of Medical Microbiology, Immunology and Hygiene, University Medical Center, Technical University of Munich, Munich, Germany.
Miriam DibosTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Florian VoitTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Johanna ErberTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Christoph D SpinnerTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Jochen SchneiderTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Julian TriebelhornTUM School of Medicine and Health, Department of Clinical Medicine, Clinical Department for Internal Medicine II, University Medical Center, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA host-protein signature score, consisting of serum-concentrations of C-reactive protein, tumour necrosis factor-related apoptosis-inducing ligand, and interferon gamma-induced protein 10, was validated for distinguishing between bacterial and viral infections as an antimicrobial stewardship measure for routine clinical practice among adult patients in a German tertiary hospital.

methodsThis single-centre, explorative study prospectively assessed the host-protein signature score, comparing it with serum procalcitonin (PCT) in patients with blood stream infections (BSI) and evaluating its efficacy in patients with viral infections against the standard of care (SOC) to assess the need for antibiotics due to suspected bacterial super/coinfection. Manufacturer-specified threshold scores were used to differentiate viral (< 35) and bacterial (> 65) infections.

resultsNinety-seven patients (BSI [n = 56]; viral infections [n = 41]) were included. The score (cut-off score > 65) tended to detect BSI with higher sensitivity than did PCT (cut-off > 0.5 ng/mL) (87.5% vs. 76.6%). Three patients (5.4%) with BSI had a score < 35. One patient with BSI did not receive antibiotic treatment following SOC prior to positive blood culture results. Among patients with viral infections, 29 (70.7%) had scores > 65, indicating bacterial superinfections. Additionally, 11 patients (26.8%) had scores < 35, indicating no bacterial superinfections. In total, the antibiotic treatment discrepancy in the viral group between the SOC and a host-protein signature score guided approach was 2/41 patients (4.9%).

conclusionThe score tended towards a higher sensitivity in detecting BSI than that with PCT. However, its impact on reducing antibiotic use in viral infections was minor compared with that of SOC.

Indexed as

Bacterial InfectionsVirus DiseasesAdultAgedAged, 80 and overAnti-Bacterial AgentsAntimicrobial StewardshipBiomarkersC-Reactive ProteinDiagnosis, DifferentialFemaleGermanyHumansMaleMiddle AgedProcalcitoninAnti-Bacterial AgentsBiomarkersC-Reactive ProteinProcalcitoninAntibioticsBlood stream infectionsC-reactive proteinInfectionProcalcitonin

Identifiers

PMID39249176
PMCPMC12137434

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.