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Wang X, Nijman R, Camuzeaux S, Sands C, Jackson H, Kaforou M, Emonts M, Herberg JA, Maconochie I, Carrol ED, Paulus SC, Zenz W, Van der Flier M, de Groot R, Martinon-Torres F, Schlapbach LJ, Pollard AJ, Fink C, Kuijpers TT, Anderson S, Lewis MR, Levin M, McClure M. Plasma lipid profiles discriminate bacterial from viral infection in febrile children. Sci Rep 2019; 9:17714. [PMID: 31776453 PMCID: PMC6881435 DOI: 10.1038/s41598-019-53721-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/03/2019] [Indexed: 11/16/2022] Open
Abstract
Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.
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Affiliation(s)
- Xinzhu Wang
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Ruud Nijman
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Stephane Camuzeaux
- National Phenome Centre and Imperial Clinical Phenotyping Centre, Department of Metabolism, Digestion and Reproduction, IRDB Building, Du Cane Road, Imperial College London, London, W12 0NN, United Kingdom
| | - Caroline Sands
- National Phenome Centre and Imperial Clinical Phenotyping Centre, Department of Metabolism, Digestion and Reproduction, IRDB Building, Du Cane Road, Imperial College London, London, W12 0NN, United Kingdom
| | - Heather Jackson
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Myrsini Kaforou
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Marieke Emonts
- Great North Children's Hospital, Paediatric Immunology, Infectious Diseases & Allergy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom
- NIHR Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom
| | - Jethro A Herberg
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Ian Maconochie
- Department of Paediatric Emergency Medicine, St Mary's Hospital, Imperial College NHS Healthcare Trust, London, W2 1NY, United Kingdom
| | - Enitan D Carrol
- Institute of Infection and Global Health, University of Liverpool, Liverpool, L69 7BE, United Kingdom
- Department of Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, United Kingdom
- Liverpool Health Partners, Liverpool, L3 5TF, United Kingdom
| | - Stephane C Paulus
- Department of Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, United Kingdom
- Liverpool Health Partners, Liverpool, L3 5TF, United Kingdom
| | - Werner Zenz
- Department of General Paediatrics, Medical University of Graz, Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria
| | - Michiel Van der Flier
- Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, 3508 AB, The Netherlands
- Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, and Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, 6500 HB, The Netherlands
| | - Ronald de Groot
- Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, and Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, 6500 HB, The Netherlands
| | - Federico Martinon-Torres
- Genetic, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain
- Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Galicia, 15706, Spain
| | - Luregn J Schlapbach
- Paediatirc Criticial Care Research Group, Child Health Research Centre, The University of Queensland and Paediatric Intensive Care Research Group, Queensland Children's Hospital, Brisbane, Australia
| | - Andrew J Pollard
- Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, OX3 9DU, United Kingdom
| | - Colin Fink
- Micropathology Ltd, University of Warwick, Warwick, CV4 7EZ, United Kingdom
| | - Taco T Kuijpers
- Division of Pediatric Hematology, Immunology and Infectious diseases, Emma Children's Hospital Academic Medical Center, Amsterdam, 1105 AZ, The Netherlands
| | - Suzanne Anderson
- Medical Research Council Unit at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Matthew R Lewis
- National Phenome Centre and Imperial Clinical Phenotyping Centre, Department of Metabolism, Digestion and Reproduction, IRDB Building, Du Cane Road, Imperial College London, London, W12 0NN, United Kingdom
| | - Michael Levin
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, London, W2 1PG, United Kingdom.
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