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

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

doi:10.1093/jpids/piac072

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Acinetobacter baumannii is a common clinical pathogen, which accounted for the top three respiratory tract isolates in 2016–2019, according to the China Antimicrobial Surveillance Network. Multidrug-resistant strains of HAP have become more frequent in clinical settings ( 14 , 19 ), contributing to a 52% Ab mortality rate ( 4 ). Hence, early identification of Ab colonization and infection is vital to prevent disease progression, reduce antibiotic abuse, and halt bacterial drug resistance.…”

Section: Discussionmentioning

confidence: 99%

“…However, clinical experimental data and diagnosis and treatment guidelines for distinction of bacterial infection and colonization are lacking. Clinicians identify pulmonary Ab infection or colonization based on the results of bacterial culture, white blood cell count (WBC) and neutrophil classification (N%), C-reactive protein (CRP), procalcitonin (PCT), and other plasma biomarker detection results combined with time consuming and subjective imaging and symptoms analysis ( 4 ). This method not only wastes time but also depends on the subjective judgment of doctors.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, WBC, CRP, and PCT are used for clinical distinction between infection and colonization ( 4 ). White blood cell count increases in response to infection and inflammation but is also affected by physiological factors, resulting in poor specificity.…”

Section: Introductionmentioning

confidence: 99%

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Utility of sTREM-1 biomarker and hcp Gene for Identification of Acinetobacter baumannii Colonization and Infection in Lung

Wang

Jiang

Wei

et al. 2023

Shock

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Objective Respiratory infections or colonization of Acinetobacter baumannii (Ab) are common in clinical practice but are treated differently. Early identification of Ab infection and colonization reduces the risk of antibiotic mismatch but objective laboratory indicators to distinguish between bacterial infections and colonization are lacking. To distinguish infection and colonization of Ab, we tested the role of two biomarkers, triggering receptor expressed on myeloid cells-1 (TREM-1) and Hemolysin co-regulated protein (Hcp). Methods A total of 96 inpatients with Ab were divided into infection and colonization groups. Blood samples were collected on day 1, 2, 3, 5, 8 and 10 and daily maximum body temperature (T) was recorded.PCR and RT-PCR were used to detect the presence and expression levels of the hcp gene in Ab clinical isolates. Results sTREM-1 and PCT levels on days 1-10 and neutrophil classification (N%) on days 1-3 were different (P < 0.05) in the infection group and colonization group.ROC curves showed significant differences in N% and sTREM-1 on days 2 and 3(P < 0.01).sTREM-1 had the highest AUCROC on days 1, 2 and 3 of all the markers. On day 1, the ROC curve of "WBC&N%&PCT&sTREM-1"was statistically different from individual indices (WBC count, N% and PCT; P < 0.05) and was equal to the ROC curve of sTREM-1 (P > 0.05). 35 of 96 patients were classified as infection group and 61 as colonization group with hcp gene detection rates of 71.43% (25/35) and 31.15% (19/61), respectively. No differences in hcp gene presence and transcript levels were found between two groups (P > 0.05). Conclusion Dynamic monitoring of sTREM-1 and PCT are valuable in identifying Ab infection and colonization. sTREM-1, can be improved by combination with multiple biomarkers in the early stage for identification of infection and colonization. The hcp gene was more likely to be present in the infection cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utility of sTREM-1 biomarker and hcp Gene for Identification of Acinetobacter baumannii Colonization and Infection in Lung

Wang

Jiang

Wei

et al. 2023

Shock

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“…This experimental method had a specificity and sensitivity of 88% and 87.5%, respectively, for detecting GAS pharyngitis 37. Host transcriptome profiles have recently been explored to distinguish symptomatic GAS pharyngitis from colonisation 38. Using peripheral blood RNA sequencing, one study demonstrated that host gene expression in symptomatic GAS pharyngitis was significantly different from asymptomatic colonisation 38…”

Section: Future Directions In Gas Pharyngitismentioning

confidence: 99%

Fifteen-minute consultation: Group A streptococcal pharyngitis, diagnosis and treatment in children

Taylor,

Webb

2024

Arch Dis Child Educ Pract Ed

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Group A streptococcus (GAS) is the most common bacterial cause of pharyngitis in children. GAS causes significant suppurative and non-suppurative complications including invasive GAS disease and acute rheumatic fever. This article describes the current epidemiology and clinical presentation of GAS pharyngitis and explores how diagnostic and treatment decisions differ globally. Several key decision support tools are discussed including international guidelines, clinical decision scores and laboratory tests along with the evidence for treatment choice and duration. With recent international reports describing an increase in GAS infections, clinicians should be familiar with their local GAS pharyngitis guidelines and the rationale for diagnosis and treatment of this common childhood illness.

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“…Two of those datasets were related to the acute phase of infection, including both viral and bacterial infection in each dataset (GSE161731 and GSE176262) [12,13]. One dataset was related to the comparison of active infection and inactive colonization of group A streptococcal (GSE158163) [14]. Another dataset was related to the comparison of the acute phase and convalescence phase of Leptospirosis (GSE72946) [15].…”

Section: Analysis Of Virsig and Bacsig In All Phases Of Acute Infectionmentioning

confidence: 99%

Quantitative and Longitudinal Assessment of Systemic Innate Immunity in Health and Disease Using a 2D Gene Model

Lei

2024

Biomedicines

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Dysregulation of innate immunity is deeply involved in infectious and autoimmune diseases. For a better understanding of pathogenesis and improved management of these diseases, it is of vital importance to implement convenient monitoring of systemic innate immunity. Built upon our previous works on the host transcriptional response to infection in peripheral blood, we proposed a 2D gene model for the simultaneous assessment of two major components of systemic innate immunity, including VirSig as the signature of the host response to viral infection and BacSig as the signature of the host response to bacterial infection. The revelation of dysregulation in innate immunity by this 2D gene model was demonstrated with a wide variety of transcriptome datasets. In acute infection, distinctive patterns of VirSig and BacSig activation were observed in viral and bacterial infection. In comparison, both signatures were restricted to a defined range in the vast majority of healthy adults, regardless of age. In addition, BacSig showed significant elevation during pregnancy and an upward trend during development. In tuberculosis (TB), elevation of BacSig and VirSig was observed in a significant portion of active TB patients, and abnormal BacSig was also associated with a longer treatment course. In cystic fibrosis (CF), abnormal BacSig was observed in a subset of patients, and no overall change in BacSig abnormality was observed after the drug treatment. In systemic sclerosis-associated interstitial lung disease (SSc-ILD), significant elevation of VirSig and BacSig was observed in some patients, and treatment with a drug led to the further deviation of BacSig from the control level. In systemic lupus erythematosus (SLE), positivity for the anti-Ro autoantibody was associated with significant elevation of VirSig in SLE patients, and the additive effect of VirSig/BacSig activation was also observed in SLE patients during pregnancy. Overall, these data demonstrated that the 2D gene model can be used to assess systemic innate immunity in health and disease, with the potential clinical applications including patient stratification, prescription of antibiotics, understanding of pathogenesis, and longitudinal monitoring of treatment response.

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

Cited by 5 publications

References 33 publications

Utility of sTREM-1 biomarker and hcp Gene for Identification of Acinetobacter baumannii Colonization and Infection in Lung

Utility of sTREM-1 biomarker and hcp Gene for Identification of Acinetobacter baumannii Colonization and Infection in Lung

Fifteen-minute consultation: Group A streptococcal pharyngitis, diagnosis and treatment in children

Quantitative and Longitudinal Assessment of Systemic Innate Immunity in Health and Disease Using a 2D Gene Model

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