Effect of a host-protein based assay on the differentiation of bacterial and viral infections in pre-school children

Clinical findings do not generally allow the differentiation of viral and bacterial infections. In the case of children with bacterial or viral infections, this diagnostic uncertainty leads to unnecessary hospital admission and antibiotic abuse, with the rapid emergence of antimicrobial resistance and the development of medical, social, and economic problems. 1 Kronman MP Zhou C Mangione-Smith R Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections. Pediatrics. 2014; 134: e956-e965 Crossref PubMed Scopus (129) Google Scholar , 2 Esposito S Tagliabue C Picciolli I et al. Procalcitonin measurements for guiding antibiotic treatment in pediatric pneumonia. Respir Med. 2011; 105: 1939-1945 Summary Full Text Full Text PDF PubMed Scopus (117) Google Scholar , 3 Nijman RG Moll HA Smit FJ et al. C-reactive protein, procalcitonin and the lab-score for detecting serious bacterial infections in febrile children at the emergency department: a prospective observational study. Pediatr Infect Dis J. 2014; 33: e273-e279 Crossref PubMed Scopus (52) Google Scholar Furthermore, a delayed or missed diagnosis of a bacterial infection can be followed by medical complications and increased mortality. 4 Craig JC Williams GJ Jones M et al. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15781 febrile illnesses. BMJ. 2010; 340: c1594 Crossref PubMed Scopus (236) Google Scholar A host-protein based assay to differentiate between bacterial and viral infections in preschool children (OPPORTUNITY): a double-blind, multicentre, validation studyThis external validation study shows the diagnostic value of a three-host protein-based assay to differentiate between bacterial and viral infections in children with lower respiratory tract infection or fever without source. This diagnostic based on CRP, TRAIL, and IP-10 has the potential to reduce antibiotic misuse in young children. Full-Text PDF