Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein
Abstract Introduction 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. Methods In a prospective study, MxA and CRP were measured in the bloo...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-12-01
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| Series: | Infectious Diseases and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40121-023-00901-2 |
| _version_ | 1797273780020576256 |
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| author | Konstantina Iliopoulou Panagiotis Koufargyris Sarantia Doulou Elisavet Tasouli Sokratis Katopodis Stavroula-Porphyria Chachali Georgios Schinas Charalampos Karachalios Myrto Astriti Paraskevi Katsaounou George Chrysos Theodoros Seferlis Effrosyni Dimopoulou Myrto Kollia Garyphalia Poulakou Styliani Gerakari Ilias C. Papanikolaou Haralampos Milionis George N. Dalekos Vasiliki Tzavara Theano Kontopoulou Evangelos J. Giamarellos-Bourboulis |
| author_facet | Konstantina Iliopoulou Panagiotis Koufargyris Sarantia Doulou Elisavet Tasouli Sokratis Katopodis Stavroula-Porphyria Chachali Georgios Schinas Charalampos Karachalios Myrto Astriti Paraskevi Katsaounou George Chrysos Theodoros Seferlis Effrosyni Dimopoulou Myrto Kollia Garyphalia Poulakou Styliani Gerakari Ilias C. Papanikolaou Haralampos Milionis George N. Dalekos Vasiliki Tzavara Theano Kontopoulou Evangelos J. Giamarellos-Bourboulis |
| author_sort | Konstantina Iliopoulou |
| collection | DOAJ |
| description | Abstract Introduction 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. Methods 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. Results 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. Conclusion The calculation of the probability for bacterial infection using MxA and CRP may efficiently discriminate between viral and bacterial respiratory infections. |
| first_indexed | 2024-03-07T14:49:06Z |
| format | Article |
| id | doaj.art-e9d8f015b61b44d5870f4b35e9a0b80d |
| institution | Directory Open Access Journal |
| issn | 2193-8229 2193-6382 |
| language | English |
| last_indexed | 2024-03-07T14:49:06Z |
| publishDate | 2023-12-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj.art-e9d8f015b61b44d5870f4b35e9a0b80d2024-03-05T19:49:40ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822023-12-0113110511910.1007/s40121-023-00901-2Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive ProteinKonstantina Iliopoulou0Panagiotis Koufargyris1Sarantia Doulou2Elisavet Tasouli3Sokratis Katopodis4Stavroula-Porphyria Chachali5Georgios Schinas6Charalampos Karachalios7Myrto Astriti8Paraskevi Katsaounou9George Chrysos10Theodoros Seferlis11Effrosyni Dimopoulou12Myrto Kollia13Garyphalia Poulakou14Styliani Gerakari15Ilias C. Papanikolaou16Haralampos Milionis17George N. Dalekos18Vasiliki Tzavara19Theano Kontopoulou20Evangelos J. Giamarellos-Bourboulis21Second Department of Internal Medicine, Thriasio General Hospital of EleusisFourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of AthensFifth Department of Internal Medicine, Evangelismos Athens General HospitalFirst Department of Internal Medicine, Thriasio General Hospital of EleusisSecond Department of Propedeutic Medicine, Medical School, National and Kapodistrian University of AthensFourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of AthensDepertment of Internal Medicine, University of PatrasThird Department of Internal Medicine and Infectious Diseases Unit, Korgialeneio-Benakeio General HospitalFirst Department of Internal Medicine, G. Gennimatas General Hospital of AthensFirst Department of Critical Care and Pulmonary Medicine, Medical School, Evangelismos General Hospital, National and Kapodistrian University of AthensSecond Department of Internal Medicine, Tzaneio General Hospital of PiraeusSecond Department of Internal Medicine, Konstantopouleio General HospitalHellenic Institute for the Study of SepsisHellenic Institute for the Study of SepsisThird Department of Internal Medicine, Medical School, National and Kapodistrian University of AthensEmergency Department, Tzaneio General Hospital of PiraeusDepartment of Pulmonary Medicine, General Hospital of Corfu “Agia Eirini”First Department of Internal Medicine, Medical School, University of IoanninaDepartment 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 LarissaFirst Department of Internal Medicine, Korgialeneio-Benakeio General HospitalFifth Department of Internal Medicine, Evangelismos Athens General HospitalFourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of AthensAbstract Introduction 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. Methods 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. Results 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. Conclusion The calculation of the probability for bacterial infection using MxA and CRP may efficiently discriminate between viral and bacterial respiratory infections.https://doi.org/10.1007/s40121-023-00901-2MxACRPBacterial infectionViral infectionDiagnosis |
| spellingShingle | Konstantina Iliopoulou Panagiotis Koufargyris Sarantia Doulou Elisavet Tasouli Sokratis Katopodis Stavroula-Porphyria Chachali Georgios Schinas Charalampos Karachalios Myrto Astriti Paraskevi Katsaounou George Chrysos Theodoros Seferlis Effrosyni Dimopoulou Myrto Kollia Garyphalia Poulakou Styliani Gerakari Ilias C. Papanikolaou Haralampos Milionis George N. Dalekos Vasiliki Tzavara Theano Kontopoulou Evangelos J. Giamarellos-Bourboulis Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein Infectious Diseases and Therapy MxA CRP Bacterial infection Viral infection Diagnosis |
| title | Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein |
| title_full | Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein |
| title_fullStr | Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein |
| title_full_unstemmed | Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein |
| title_short | Developing a Tool for Differentiation Between Bacterial and Viral Respiratory Infections Using Myxovirus Resistance Protein A and C-Reactive Protein |
| title_sort | developing a tool for differentiation between bacterial and viral respiratory infections using myxovirus resistance protein a and c reactive protein |
| topic | MxA CRP Bacterial infection Viral infection Diagnosis |
| url | https://doi.org/10.1007/s40121-023-00901-2 |
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