Host-Based Diagnostics for Acute Respiratory Infections

Abstract

Purpose: The inappropriate use of antimicrobials, especially in acute respiratory infections (ARIs), is largely driven by difficulty distinguishing bacterial, viral, and noninfectious etiologies of illness. A new frontier in infectious disease diagnostics looks to the host response for disease classification. This article examines how host responseebased diagnostics for ARIs are being used in clinical practice, as well as new developments in the research pipeline. Methods: A limited search was conducted of the relevant literature, with emphasis placed on literature published in the last 5 years (2014e2019). Findings: Advances are being made in all areas of host responseebased diagnostics for ARIs. Specifically, there has been significant progress made in single protein biomarkers, as well as in various "omics" fields (including proteomics, metabolomics, and transcriptomics) and wearable technologies. There are many potential applications of a host responseebased approach; a few key examples include the ability to discriminate bacterial and viral disease, presymptomatic diagnosis of infection, and pathogen-specific host response diagnostics, including modeling disease progression. Implications: As biomarker measurement technologies continue to improve, host responseebased diagnostics will increasingly be translated to clinically available platforms that can generate a holistic characterization of an individual's health. This knowledge, in the hands of both patient and provider, can improve care for the individual patient and help fight rising rates of antibiotic resistance. (Clin Ther.

Validation of a host response test to distinguish bacterial and viral respiratory infection

“…Pathogen-detection tests encompass many technologies including culture, rapid antigen detection tests, and nucleic acid amplification tests. Advantages and disadvantages of these approaches have been reviewed elsewhere [46]. However, one of the limitations common to all is the inability to distinguish infection from colonization (asymptomatic shedding), which has been observed for all the pathogens included on these various test panels [[47],[48]].…”

Hubungan Antara Status Gizi Dengan Kejadian ISPA Pada Anak Usia Toddler (1-3 Tahun)

“…Baru-baru ini terdapat penelitin bahwa klasifikasi penyakit lebih banyak mengarah ke perawatan ISPA. Banyak dari penelitian ini berfokus pada diferensiasi antara bakteri, virus, dan penyakit tidak menular di Indonesia yakni pasien dengan imunokompeten (Ross, Zick, & Tsalik, 2019).…”

Novel point-of-care biomarker combination tests to differentiate acute bacterial from viral respiratory tract infections to guide antibiotic prescribing: a systematic review

“…Bacterial and viral aetiologies in RTIs have measurable differences in host-response, allowing these biomarkers to be surrogate markers of infection aetiology. (41,42) C-reactive protein (CRP) and procalcitonin (PCT) increase more extensively in bacterial than in non-bacterial RTIs and, when used to guide treatment, meta-analyses of experimental research has shown significant reductions in antibiotic prescription compared with normal practice. (43)(44)(45)(46) However, lone biomarkers have limitations as CRP has insufficient diagnostic accuracy, disputed correlation with bacterial load and can produce drastic increases in response to some viruses while the diagnostic accuracy of PCT has been shown to vary significantly.…”