Optimal combination of early biomarkers for infection and sepsis diagnosis in the emergency department: The BIPS study - 02/04/21
Highlights |
• | Combination of plasma and cell surface biomarkers are useful to discriminate suspected infected patients. |
• | Combination of HLA-DR, Mertk and MMP8 is performant for bacterial infection diagnosis. |
• | Combination of CD64, CD24 and CX3CR1 is performant for viral infection diagnosis. |
• | Combination of HLA-DR, PCT and IL-6 is performant for sepsis-2 diagnosis. |
Abstract |
Objective |
: To define the best combination of biomarkers for the diagnosis of infection and sepsis in the emergency room.
Methods |
: In this prospective study, consecutive patients with a suspicion of infection in the emergency room were included. Eighteen different biomarkers measured in plasma, and twelve biomarkers measured on monocytes, neutrophils, B and T-lymphocytes were studied and the best combinations determined by a gradient tree boosting approach.
Results |
: Overall, 291 patients were included and analysed, 148 with bacterial infection, and 47 with viral infection. The best biomarker combination which first allowed the diagnosis of bacterial infection, included HLA-DR (human leukocyte antigen DR) on monocytes, MerTk (Myeloid-epithelial-reproductive tyrosine kinase) on neutrophils and plasma metaloproteinase-8 (MMP8) with an area under the curve (AUC) = 0.94 [95% confidence interval (IC95): 0.91;0.97]. Among patients in whom a bacterial infection was excluded, the combination of CD64 expression, and CD24 on neutrophils and CX3CR1 on monocytes ended to an AUC = 0.98 [0.96;1] to define those with a viral infection.
Conclusion |
: In a convenient cohort of patients admitted with a suspicion of infection, two different combinations of plasma and cell surface biomarkers were performant to identify bacterial and viral infection.
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Vol 82 - N° 4
P. 11-21 - avril 2021 Retour au numéro
Article précédent
- Distinguishing bacterial versus non-bacterial causes of febrile illness – A systematic review of host biomarkers
- B. Leticia Fernandez-Carballo, Camille Escadafal, Emily MacLean, Anokhi J. Kapasi, Sabine Dittrich
- Metagenomic next-generation sequencing for the diagnosis of suspected pneumonia in immunocompromised patients
- Jin-Min Peng, Bin Du, Han-Yu Qin, Qian Wang, Yan Shi
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