Eimear Kelly (United Kingdom)
Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK. Department of PaediatricsAuthor Of 1 Presentation
SYSTEMATIC REVIEW OF HOST GENOMIC BIOMARKERS OF INVASIVE BACTERIAL DISEASE: DISTINGUISHING BACTERIAL FROM NON-BACTERIAL CAUSES OF ACUTE FEBRILE ILLNESS.
Abstract
Backgrounds:
Infectious diseases play a significant role in the global burden of disease. The gold standard for the diagnosis of bacterial infection, culture of bacteria, can lead to diagnostic delays and unnecessary antibiotic use. The advent of high-throughput microarray and sequencing has led to the discovery of host-based genomic biomarkers, capable of differentiating bacterial from other causes of infection but few have achieved validation for use in a clinical setting.
Methods
A systematic review was performed. PubMed/Ovid Medline, Ovid Embase and Scopus databases were searched for relevant studies from inception up to 21/09/2020 with forward and backward citation searching of key references. Studies which compared the diagnostic performance of host genomic biomarkers of bacterial infection to those with non-bacterial sources of infection were included. Study selection and assessment of quality was conducted by two independent reviewers. Meta-analysis was undertaken for all included genomic signatures using a diagnostic random-effects model. The review was registered with PROSPERO (ID: CRD42021208462).
Results:
Sixty-eight studies which evaluated the performance of 110 biomarkers in 15,299 patients were included. Forty-seven studies examined the performance of biomarkers specific to TB infection and twenty studies were conducted in a paediatric population. The results of pooled sensitivity, specificity, negative and positive likelihood ratio and diagnostic odds ratio of genomic biomarkers of bacterial infection were 0.81 (95% CI 0.78 to 0.83), 0.86 (95% CI 0.84 to 0.88), 0.18 (95% CI 0.15 to 0.21), 5.7 (95% CI 5.0 to 6.5), 31.3 (95% CI 25 to 39), respectively. Significant heterogeneity (I2 77%) was present.
Conclusions/Learning Points:
Host derived genomic biomarkers show significant potential for clinical use as diagnostic tests of bacterial infection however, further validation and attention to test platform is warranted before clinical implementation can be achieved.
Presenter of 1 Presentation
SYSTEMATIC REVIEW OF HOST GENOMIC BIOMARKERS OF INVASIVE BACTERIAL DISEASE: DISTINGUISHING BACTERIAL FROM NON-BACTERIAL CAUSES OF ACUTE FEBRILE ILLNESS.
Abstract
Backgrounds:
Infectious diseases play a significant role in the global burden of disease. The gold standard for the diagnosis of bacterial infection, culture of bacteria, can lead to diagnostic delays and unnecessary antibiotic use. The advent of high-throughput microarray and sequencing has led to the discovery of host-based genomic biomarkers, capable of differentiating bacterial from other causes of infection but few have achieved validation for use in a clinical setting.
Methods
A systematic review was performed. PubMed/Ovid Medline, Ovid Embase and Scopus databases were searched for relevant studies from inception up to 21/09/2020 with forward and backward citation searching of key references. Studies which compared the diagnostic performance of host genomic biomarkers of bacterial infection to those with non-bacterial sources of infection were included. Study selection and assessment of quality was conducted by two independent reviewers. Meta-analysis was undertaken for all included genomic signatures using a diagnostic random-effects model. The review was registered with PROSPERO (ID: CRD42021208462).
Results:
Sixty-eight studies which evaluated the performance of 110 biomarkers in 15,299 patients were included. Forty-seven studies examined the performance of biomarkers specific to TB infection and twenty studies were conducted in a paediatric population. The results of pooled sensitivity, specificity, negative and positive likelihood ratio and diagnostic odds ratio of genomic biomarkers of bacterial infection were 0.81 (95% CI 0.78 to 0.83), 0.86 (95% CI 0.84 to 0.88), 0.18 (95% CI 0.15 to 0.21), 5.7 (95% CI 5.0 to 6.5), 31.3 (95% CI 25 to 39), respectively. Significant heterogeneity (I2 77%) was present.
Conclusions/Learning Points:
Host derived genomic biomarkers show significant potential for clinical use as diagnostic tests of bacterial infection however, further validation and attention to test platform is warranted before clinical implementation can be achieved.