A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
A rapid flow cytometric method for distinguishing between febrile bacterial and viral infections
Tekijät: Nuutila J, Jalava-Karvinen P, Hohenthal U, Kotilainen P, Pelliniemi TT, Nikoskelainen J, Lilius EM
Kustantaja: Elsevier
Julkaisuvuosi: 2013
Journal: Journal of Microbiological Methods
Tietokannassa oleva lehden nimi: JOURNAL OF MICROBIOLOGICAL METHODS
Lehden akronyymi: J MICROBIOL METH
Vuosikerta: 92
Numero: 1
Aloitussivu: 64
Lopetussivu: 72
Sivujen määrä: 9
ISSN: 0167-7012
DOI: https://doi.org/10.1016/j.mimet.2012.11.005
Tiivistelmä
Antibiotic resistance due to the inappropriate use of antimicrobials is one of the most critical public health
problems worldwide. A major factor underlying the unnecessary use of antibiotics is the lack of rapid and
accurate diagnostic tests. Therefore, we aimed to develop a novel rapid flow cytometric method for
distinguishing between febrile bacterial and viral infections.
In this prospective comparative study, quantitative flow cytometric analysis of FcγRII/CD32, CR1/CD35, MHC
Class I receptor (MHCI), and C5aR/CD88 on human phagocytes was performed in 286 hospitalized febrile patients
with suspected infection. After using microbiological and serological detection methods, or clinical diagnosis,
205 patients were identified with either bacterial (n=136) or viral (n=69) infection. Receptor data
from patients were compared to those of 50 healthy controls.
We developed a flow cytometric marker of local and systemic bacterial infections designated “bacterial infection
score (BIS)” incorporating the quantitative analysis of FcγRII/CD32, CR1/CD35, C5aR/CD88 and MHCI on
neutrophils and/or monocytes, which displays 91% sensitivity and 92% specificity in distinguishing between
microbiologically confirmed bacterial (n=77) and serologically confirmed viral infections (n=61) within
1 h. The BISmethodwas effectively applied to distinguish between bacterial and viral (pandemic H1N1 influenza)
pneumonia cases with 96% sensitivity and 92% specificity.
We propose that the rapid BIS test can assist physicians in deciding whether antibiotic treatment is necessary,
thus reducing unnecessary antimicrobial use.
Antibiotic resistance due to the inappropriate use of antimicrobials is one of the most critical public health
problems worldwide. A major factor underlying the unnecessary use of antibiotics is the lack of rapid and
accurate diagnostic tests. Therefore, we aimed to develop a novel rapid flow cytometric method for
distinguishing between febrile bacterial and viral infections.
In this prospective comparative study, quantitative flow cytometric analysis of FcγRII/CD32, CR1/CD35, MHC
Class I receptor (MHCI), and C5aR/CD88 on human phagocytes was performed in 286 hospitalized febrile patients
with suspected infection. After using microbiological and serological detection methods, or clinical diagnosis,
205 patients were identified with either bacterial (n=136) or viral (n=69) infection. Receptor data
from patients were compared to those of 50 healthy controls.
We developed a flow cytometric marker of local and systemic bacterial infections designated “bacterial infection
score (BIS)” incorporating the quantitative analysis of FcγRII/CD32, CR1/CD35, C5aR/CD88 and MHCI on
neutrophils and/or monocytes, which displays 91% sensitivity and 92% specificity in distinguishing between
microbiologically confirmed bacterial (n=77) and serologically confirmed viral infections (n=61) within
1 h. The BISmethodwas effectively applied to distinguish between bacterial and viral (pandemic H1N1 influenza)
pneumonia cases with 96% sensitivity and 92% specificity.
We propose that the rapid BIS test can assist physicians in deciding whether antibiotic treatment is necessary,
thus reducing unnecessary antimicrobial use.
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