Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein.

Bacterial infection CRP Diagnosis MxA Viral infection

Journal

Infectious diseases and therapy
ISSN: 2193-8229
Titre abrégé: Infect Dis Ther
Pays: New Zealand
ID NLM: 101634499

Informations de publication

Date de publication:
19 Dec 2023
Historique:
received: 07 11 2023
accepted: 04 12 2023
medline: 19 12 2023
pubmed: 19 12 2023
entrez: 19 12 2023
Statut: aheadofprint

Résumé

The aim was to assess the performance of a blood assay combining measurements of MxA (myxovirus resistance protein A) and CRP (C-reactive protein) to differentiate viral from bacterial respiratory infections. In a prospective study, MxA and CRP were measured in the blood by the AFIAS panel in adults admitted with respiratory infection. Patients were split into discovery and validation cohorts. Final diagnosis was adjudicated by a panel of experts. Microbiology-confirmed cases comprised the discovery cohort, and infections adjudicated as highly probable viral or bacterial comprised the validation cohort. A total of 537 patients were analyzed: 136 patients were adjudicated with definitive viral infections and 131 patients with definitive bacterial infections. Using logistic regression analysis, an equation was developed to calculate the probability for bacterial infection using the absolute value of MxA and CRP. Calculated probability ≥ 0.5 and/or MxA to CRP ratio less than 2 applied as the diagnostic rule for bacterial infections. This rule provided 91.6% sensitivity and 90.4% negative predictive value for the diagnosis of bacterial infections. This diagnostic sensitivity was confirmed in the validation cohort. A MxA/CRP ratio less than 0.15 was associated with unfavorable outcome. The calculation of the probability for bacterial infection using MxA and CRP may efficiently discriminate between viral and bacterial respiratory infections.

Identifiants

DOI: 10.1007/s40121-023-00901-2 PMID: 38112973
pubmed: 38112973
doi: 10.1007/s40121-023-00901-2
pii: 10.1007/s40121-023-00901-2
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

© 2023. The Author(s).

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Auteurs

Konstantina Iliopoulou (K)

Second Department of Internal Medicine, Thriasio General Hospital of Eleusis, Athens, Greece.

Panagiotis Koufargyris (P)

Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 124 62, Athens, Greece.

Sarantia Doulou (S)

Fifth Department of Internal Medicine, Evangelismos Athens General Hospital, Athens, Greece.

Elisavet Tasouli (E)

First Department of Internal Medicine, Thriasio General Hospital of Eleusis, Athens, Greece.

Sokratis Katopodis (S)

Second Department of Propedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Stavroula-Porphyria Chachali (SP)

Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 124 62, Athens, Greece.

Georgios Schinas (G)

Depertment of Internal Medicine, University of Patras, Rion, Greece.

Charalampos Karachalios (C)

Third Department of Internal Medicine and Infectious Diseases Unit, Korgialeneio-Benakeio General Hospital, Athens, Greece.

Myrto Astriti (M)

First Department of Internal Medicine, G. Gennimatas General Hospital of Athens, Athens, Greece.

Paraskevi Katsaounou (P)

First Department of Critical Care and Pulmonary Medicine, Medical School, Evangelismos General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

George Chrysos (G)

Second Department of Internal Medicine, Tzaneio General Hospital of Piraeus, Athens, Greece.

Theodoros Seferlis (T)

Second Department of Internal Medicine, Konstantopouleio General Hospital, Athens, Greece.

Effrosyni Dimopoulou (E)

Hellenic Institute for the Study of Sepsis, Athens, Greece.

Myrto Kollia (M)

Hellenic Institute for the Study of Sepsis, Athens, Greece.

Garyphalia Poulakou (G)

Third Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Styliani Gerakari (S)

Emergency Department, Tzaneio General Hospital of Piraeus, Athens, Greece.

Ilias C Papanikolaou (IC)

Department of Pulmonary Medicine, General Hospital of Corfu "Agia Eirini", Kontokali, Greece.

Haralampos Milionis (H)

First Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.

George N Dalekos (GN)

Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, Full Member of the European Reference Network on Hepatological Disases (ERN RARE-LIVER), General University Hospital of Larissa, 41110, Larissa, Greece.

Vasiliki Tzavara (V)

First Department of Internal Medicine, Korgialeneio-Benakeio General Hospital, Athens, Greece.

Theano Kontopoulou (T)

Fifth Department of Internal Medicine, Evangelismos Athens General Hospital, Athens, Greece.
First Department of Internal Medicine, Evangelismos Athens General Hospital, Athens, Greece.

Evangelos J Giamarellos-Bourboulis (EJ)

Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, 124 62, Athens, Greece. egiamarel@med.uoa.gr.
Hellenic Institute for the Study of Sepsis, Athens, Greece. egiamarel@med.uoa.gr.
ORCID: 0000-0003-4713-3911

Classifications MeSH