Researchers at Imperial College London identified two genes that became activated when children became ill from an infection linked to bacteria rather than a virus, leading them to establish a diagnostic test that may distinguish between infection types, according to recently published findings.
“Fever is one of the most common reasons children are brought to medical care,” Michael Levin, FRCPCH, professor in the department of medicine at Imperial College London, said in a press release. “However, every year many children are sent away from EDs or doctors’ surgeries because the medical team thinks they have a viral infection, when in fact they are suffering from life-threatening bacterial infections. Conversely, many other children are admitted to hospital and receive antibiotics because the medical team are unable to immediately exclude the possibility of a bacterial infection — but in fact they are suffering from a virus.”
To evaluate whether febrile children with a virus can be differentiated from those affected by a bacterial infection, Levin and colleagues conducted a cross-sectional study that included 370 febrile children in London, Spain, the Netherlands and the United States. Patients in the 4-year study were sorted into a discovery (n = 240) and a validation (n = 130) group after they underwent microbial investigation for definite bacterial (discovery group, n = 52; validation group, n = 23), viral (discovery, n = 92; validation, n = 28) or indeterminate (discovery, n = 96; validation, n = 79) infection. The researchers then examined genes that had switched places on the patients’ white blood cells.
RNA micro arrays data showed that 2-transcript host RNA signature genes, IFI44L and FAM89A, became switched on in bacterial infections. In further analysis, among those with confirmed bacterial infection, these genes predicted bacterial infections with 100% accuracy with 2-transcript RNA signature in the validation group (95% CI, 100-100). Among those with definite viral infection, the genes showed a specificity of 96.4% (95% CI, 89.3-100) for viral infection.
“Although this research is at an early stage, the results show bacterial infection can be distinguished from other causes of fever, such as a viral infection, using the pattern of genes that are switched on or off in response to the infection,” Levin said in the release. “The challenge is now to transform our findings into a diagnostic test that can be used in hospital emergency departments or general practice surgeries, to identify those children who need antibiotics.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.