Maurizio Macaluso (United States of America)

Cincinnati Children's Hospital Medical Center Pediatrics

Author Of 1 Presentation

 Conference Calendar

DISCRIMINATION OF VIRAL FROM BACTERIAL COMMUNITY ACQUIRED PNEUMONIA IN CHILDREN USING URINE METABOLOMICS

Date
Fri, 13.05.2022
Session Time
10:00 - 11:30
Session Type
Oral Presentations Session
Session Name
0900 - ORAL PRESENTATION SESSION 10: Biomarkers & Diagnostics (ID 108)
Room
MC 2 HALL
Presenter
Lecture Time
10:52 - 11:02

Abstract

Backgrounds:

Differentiating bacterial from viral etiologies of pediatric community-acquired pneumonia (CAP) is critical to guiding appropriate therapy. However, current tests are insensitive, invasive, or impractical in children. The objective of this study is to identify candidate metabolomic biomarkers that differentiate bacteria from viral CAP.

Methods

We studied a cohort of children, 3 months-18 years old, with suspected CAP in the emergency department. Patients with chronic medical conditions or who were hospitalized 14 days prior were excluded. Viral and Mycoplasma pneumoniae (Mp) were detected by PCR of nasopharyngeal swabs. Suspected Streptococcus pneumoniae (Sp) was defined as presence of pneumococcal autolysin (lytA) and a procalcitonin of ≥1.5 ng/mL. Urine samples were collected at time of presentation and metabolites were identified and quantified by nuclear magnetic resonance spectroscopy. Metabolomics data were standardized using specific gravity. Demographic and clinical characteristics by patient status ( MP, Sp and viral) were compared using chi-square tests and ANOVA, as applicable. Random forest (RF) was used to determine the most important metabolites and clinical factors to discriminate viral etiology from Mp and Sp.

Results:

Of 160 children, 28 (17.5%) had Mp, 13 (8.1%) had Sp, and 119 (74.4%) had a virus detected by PCR (Table). Most (87%) were between 1-12 years old. The most important variables identified by RF included age, prior history of reactive airways disease, 1-methylnicotinamide, hypoxanthine, tryptophan, quinolinate, valine, trimethylamine-N-oxide, ascorbate, and 4-hydroxybenzoate.

aim 2b table_page_1.jpg

Conclusions/Learning Points:

Metabolites related to inflammatory pathways (e.g., tryptophan, quniolinate) and microbial metabolism (e.g., trimethylamine-N-oxide, 4-hydroxybenzoate) differentiated viral from typical and atypical bacterial CAP in children. Urine metabolomics can identify novel biomarkers to differentiate bacterial from viral CAP in children.

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