MxA for differentiating viral and bacterial infections in adults: a prospective, exploratory study.

Purpose: Inappropriate antibiotic prescription in patients with viral infections contributes to the surge of antibiotic resistance. Viral infections induce the expression of the antiviral protein MxA in monocytes, which is a promising biomarker to differentiate between viral and bacterial diseases....

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Publicado en:Infection Vol. 51; no. 5; pp. 1329 - 1338
Autores principales: Metz, Matthäus, Gualdoni, Guido A., Winkler, Heide-Maria, Warenits, Alexandra-Maria, Stöckl, Johannes, Burgmann, Heinz, Winkler, Stefan, Oesterreicher, Zoe Anne
Formato: research tables/charts Journal Article
Publicado: Springer Nature Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-023-01986-0
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        atl: MxA for differentiating viral and bacterial infections in adults: a prospective, exploratory study.
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          Metz, Matthäus
          Gualdoni, Guido A.
          Winkler, Heide-Maria
          Warenits, Alexandra-Maria
          Stöckl, Johannes
          Burgmann, Heinz
          Winkler, Stefan
          Oesterreicher, Zoe Anne
        affil: https://ror.org/05n3x4p02 Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, 1090, Vienna, Austria
      sug:
        subj:
          Bacterial Infections Diagnosis
          Coinfection Diagnosis
          Virus Diseases Diagnosis
          Carrier Proteins Metabolism
          Drug Resistance, Microbial
          Human
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Prospective Studies
          Exploratory Research
          Monocytes
          Flow Cytometry
          Immunosuppression Methods
          ROC Curve
          Sensitivity and Specificity
          Biological Markers
          One-Way Analysis of Variance
          Fisher's Exact Test
          Kruskal-Wallis Test
          Data Analysis Software
          Descriptive Statistics
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Purpose: Inappropriate antibiotic prescription in patients with viral infections contributes to the surge of antibiotic resistance. Viral infections induce the expression of the antiviral protein MxA in monocytes, which is a promising biomarker to differentiate between viral and bacterial diseases. In this prospective, exploratory study, we aimed to determine the diagnostic value of monocyte MxA expression in adults with viral, bacterial or co-infections. Methods: We measured monocyte MxA expression using flow cytometry in a cohort of 61 adults with various viral, bacterial and co-infections including patients receiving immunosuppressive therapy. Results: Monocyte MxA expression in virus-infected patients was significantly higher compared to bacterial infections (83.3 [66.8, 109.4] vs. 33.8 [29.3, 47.8] mean fluorescence intensity [MFI]; p < 0.0001) but not co-infections (53.1 [33.9, 88.9] MFI). At a threshold of 62.2 MFI, the area under the ROC curve (AUC) to differentiate between viral and bacterial infections was 0.9, with a sensitivity and specificity of 92.3% and 84.6%, respectively. Immunosuppressive therapy did not affect monocyte MxA expression in virus-infected patients. Conclusion: Our findings corroborate the diagnostic performance of MxA in differentiating viral and bacterial infections but also point to an important caveat of MxA in viral-bacterial co-infections. This study extends previous reports and indicates that MxA is also a useful biomarker in immunocompromised patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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