scholarly journals Diagnostic Value of Mid-regional Pro-adrenomedullin (MR-proADM) as a Biomarker of Invasive Bacterial Infection in Children: A Systematic Review.

2020 ◽  
Author(s):  
Michael Corr ◽  
Derek Fairley ◽  
James McKenna ◽  
Michael Shields ◽  
Thomas Waterfield
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Diagnostic Accuracy ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Signs And Symptoms ◽  
Test Accuracy ◽  
Systematic Analysis ◽  
Invasive Bacterial Infection

Abstract BackgroundIn children differentiating between the early stages of an invasive bacterial infection (IBI) and a benign self-limiting viral infection remains clinically challenging. This often leads to an over-use of antimicrobial drugs with resultant antimicrobial resistance due to the concern of not detecting a deteriorating child. Hence research into novel biomarkers for the early identification of IBI in children is of increasing interest. A more timely diagnosis through more accurate biomarkers may lead to improved clinical outcomes for children and reduced antimicrobial resistance. Mid-regional pro-adrenomedullin (MR-proADM) is a biomarker that is found at elevated levels in patients with IBI compared with those with viral infections. The aim of this systematic review was to determine the diagnostic accuracy of MR-proADM at identifying children with IBI. MethodsWe searched MEDLINE, Embase, Web of Science and Scopus from 1980 to the present day for all human clinical trials involving children that report the test accuracy of MR-proADM. Eligibility was assessed by screening titles and abstracts of articles found during the search process. This was then followed by full-text assessment and data extraction. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the methodological quality of identified studies. The following test characteristics were extracted into 2 × 2 tables for all included studies: true positives, false positives, true negatives, and false negatives. ResultsA total of 501 articles were initially identified. After the removal of duplicates and abstract screening 11 texts were fully reviewed. 4 studies (totaling 1404 patients) were able to be included in the systematic analysis. Only one study was of a high quality and that study accounted for the vast majority of patients. A single study reported the diagnostic accuracy of MR-proADM for invasive bacterial infection reporting an Area under the Curve of 0.69. The paucity of available studies made meta-analysis and studies of heterogeneity impossible.ConclusionThere is a paucity of research regarding the diagnostic accuracy of MR-proADM in the diagnosis of invasive bacterial infections in children. Initial results would suggest that MR-proADM testing alone is poor at identifying IBI in young children. It remains unclear if MR-proADM performs differently in older children or in children with signs and symptoms of IBI. Trial registrationPROSPERO CRD42018096295

scholarly journals Human Neutrophil Lipocalin as a Superior Diagnostic Means To Distinguish between Acute Bacterial and Viral Infections

2015 ◽  
Vol 22 (9) ◽  
pp. 1025-1032 ◽  
Author(s):  
Per Venge ◽  
Lena Douhan-Håkansson ◽  
Daniel Garwicz ◽  
Christer Peterson ◽  
Shengyuan Xu ◽  
...  
Keyword(s):  
Whole Blood ◽  
Human Neutrophil ◽  
Bacterial Infections ◽  
Viral Infections ◽  
Response Times ◽  
Clinical Performance ◽  
Point Of Care ◽  
Signs And Symptoms ◽  
Healthy Controls ◽  
Acute Infections

ABSTRACTThe distinction between causes of acute infections is a major clinical challenge. Current biomarkers, however, are not sufficiently accurate. Human neutrophil lipocalin (HNL) concentrations in serum or whole blood activated by formyl-methionine-leucine-phenylalanine (fMLP) were shown to distinguish acute infections of bacterial or viral cause with high accuracy. The aim was therefore to compare the clinical performance of HNL with currently used biomarkers. Seven hundred twenty-five subjects (144 healthy controls and 581 patients with signs and symptoms of acute infections) were included in the study. C-reactive protein (CRP), the expression of CD64 on neutrophils, procalcitonin (PCT), and blood neutrophil counts were measured by established techniques, and HNL concentrations were measured in whole-blood samples after activation with fMLP. All tested biomarkers were elevated in bacterial as opposed to viral infections (P< 0.001). CRP, PCT, and CD64 expression in neutrophils was elevated in viral infections compared to healthy controls (P< 0.001). In the distinction between healthy controls and patients with bacterial infections, the areas under the receiver operating characteristic (ROC) curves were >0.85 for all biomarkers, whereas for the distinction between bacterial and viral infections, only HNL concentration in fMLP-activated whole blood showed an area under the ROC curve (AUROC) of >0.90 and superior clinical performance. The clinical performance of HNL in fMLP-activated whole blood was superior to current biomarkers and similar to previous results of HNL in serum. The procedure can be adopted for point-of-care testing with response times of <15 min.

scholarly journals The diagnostic accuracy of isothermal nucleic acid point-of-care tests for human coronaviruses: A systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pakpoom Subsoontorn ◽  
Manupat Lohitnavy ◽  
Chuenjid Kongkaew
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Point Of Care ◽  
Meta Analysis ◽  
Isothermal Amplification ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Index Test ◽  
Point Of Care Tests

AbstractMany recent studies reported coronavirus point-of-care tests (POCTs) based on isothermal amplification. However, the performances of these tests have not been systematically evaluated. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy was used as a guideline for conducting this systematic review. We searched peer-reviewed and preprint articles in PubMed, BioRxiv and MedRxiv up to 28 September 2020 to identify studies that provide data to calculate sensitivity, specificity and diagnostic odds ratio (DOR). Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was applied for assessing quality of included studies and Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) was followed for reporting. We included 81 studies from 65 research articles on POCTs of SARS, MERS and COVID-19. Most studies had high risk of patient selection and index test bias but low risk in other domains. Diagnostic specificities were high (> 0.95) for included studies while sensitivities varied depending on type of assays and sample used. Most studies (n = 51) used reverse transcription loop-mediated isothermal amplification (RT-LAMP) to diagnose coronaviruses. RT-LAMP of RNA purified from COVID-19 patient samples had pooled sensitivity at 0.94 (95% CI: 0.90–0.96). RT-LAMP of crude samples had substantially lower sensitivity at 0.78 (95% CI: 0.65–0.87). Abbott ID Now performance was similar to RT-LAMP of crude samples. Diagnostic performances by CRISPR and RT-LAMP on purified RNA were similar. Other diagnostic platforms including RT- recombinase assisted amplification (RT-RAA) and SAMBA-II also offered high sensitivity (> 0.95). Future studies should focus on the use of un-bias patient cohorts, double-blinded index test and detection assays that do not require RNA extraction.

scholarly journals Prevalence of Sepsis and Possible Severe Bacterial Infection among Neonates in Nepal

2018 ◽  
Vol 16 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Gambhir Shrestha ◽  
Rashmi Mulmi ◽  
Nibaran Joshi ◽  
Parashu Ram Shrestha
Keyword(s):  
Systematic Review ◽  
Bacterial Infection ◽  
Neonatal Sepsis ◽  
Signs And Symptoms ◽  
Nationwide Survey ◽  
Community Based ◽  
Eligibility Criteria ◽  
Severe Bacterial Infection ◽  
Review Criteria ◽  
Adequate Data

Nepal lacks adequate data on the prevalence of sepsis and Possible Severe Bacterial Infection (PSBI) among neonates. Thus, this systematic review was designed to estimate the prevalence of neonatal sepsis and PSBI status in Nepal. We searched PubMed and Nepal Journal Online for relevant studies on PSBI and neonatal sepsis published from 2006 to 2016. The eligibility criteria included those studies done in Nepal, evaluating the prevalence of PSBI/neonatal sepsis with denominators as the population at risk that is either total live births or total cases evaluated. Altogether, four studies met the review criteria, out of which three were hospital-based and one community-based. There is a vast difference in prevalence rate between hospital-based (2-4%) and community-based (9%) studies. Two studies used haematological scoring system and blood culture to base their diagnosis; one used signs and symptoms for PSBI while the other did not mention the diagnostic criteria. This systematic review suggests that though neonatal sepsis poses a big problem, it lacks a significant number of related studies. There is a need to conduct a nationwide survey on the prevalence of sepsis and PSBI among neonates, which will help to develop health policy.

scholarly journals Diagnostic accuracy of refractometer and Brix refractometer to assess failure of passive transfer in calves: protocol for a systematic review and meta-analysis

2016 ◽  
Vol 17 (1) ◽  
pp. 3-8 ◽  
Author(s):  
S. Buczinski ◽  
G. Fecteau ◽  
M. Chigerwe ◽  
J. M. Vandeweerd
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Passive Transfer ◽  
Standard Test ◽  
Passive Immunity ◽  
Test Accuracy ◽  
Reference Standard ◽  
Review Protocol ◽  
The Impact

AbstractCalves are highly dependent of colostrum (and antibody) intake because they are born agammaglobulinemic. The transfer of passive immunity in calves can be assessed directly by dosing immunoglobulin G (IgG) or by refractometry or Brix refractometry. The latter are easier to perform routinely in the field. This paper presents a protocol for a systematic review meta-analysis to assess the diagnostic accuracy of refractometry or Brix refractometry versus dosage of IgG as a reference standard test. With this review protocol we aim to be able to report refractometer and Brix refractometer accuracy in terms of sensitivity and specificity as well as to quantify the impact of any study characteristic on test accuracy.

scholarly journals Diagnostic accuracy of Yale observational scale in bacteremia in infants and children.

2020 ◽  
Vol 27 (07) ◽  
pp. 1346-1352
Author(s):  
Motia Javed ◽  
Mehboob Alam Siddiqui ◽  
Zahid Mahmood Anjum ◽  
Fazal Elahi Bajwa ◽  
Hina Ayesha
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Rural Areas ◽  
Viral Infections ◽  
Signs And Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Observation Scale ◽  
Viable Bacteria ◽  
Yale Observation Scale

Bacteremia is the presence of viable bacteria in the circulating blood. Bacteremia is diagnosed by blood culture. Yale Observation Scale (YOS) is a scale consisting of six observational items originally and is validated in young febrile children to detect serious illness. If YOS found to be highly accurate, it will help us to design a protocol for early screening and diagnosis of bacteremia in infants so that patient’s morbidity and mortality can be minimized by early treatment. Objectives: To determine the diagnostic accuracy of Yale Observation Scale (YOS) for diagnosing bacteremia, taking blood culture as gold standard. Study Design: Cross-Sectional Validation study. Setting: Department of Pediatrics, D.H.Q Hospital, Faisalabad. Period: 26th May, 2016 to 25th November, 2016. Material & Methods: One hundred and five patients suffering from fever>38 0C, having age from 3-36 months were included in the study. Patients already taking antibiotics, immune compromised, patients with signs and symptoms of malaria or viral infections were excluded. YOS was calculated and blood culture was performed in all patients to diagnose bacteremia. Results: Out of 105 patients, mean age was 12.9±8.24 months. There were 55(52.4%) male and 50(47.6%) female patients. Sensitivity of YOS in diagnosing bacteremia was 90.63%, specificity 79.45%, PPV 65.91%, NPV 95.08% and diagnostic accuracy was 82.86%. Conclusion: YOS can be used as a key diagnostic tool in detecting bacteremia. So, by using this tool many cases in the rural areas can be diagnosed and managed early.

scholarly journals Viral and bacterial infection elicit distinct changes in plasma lipids in febrile children

2019 ◽  
Author(s):  
Xinzhu Wang ◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
Heather Jackson ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Plasma Lipids ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
The Uk

AbstractFever is the most common reason that children present to Emergency Departments in the UK. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. As a result, many children are prescribed antibiotics often unnecessarily, while others with life-threatening bacterial infections can remain untreated. 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 elicit distinct changes in the host lipidome. Glycerophosphoinositol, sphingomyelin, lysophosphotidylcholine and cholesterol sulfate were increased in the confirmed virus infected group, while fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were increased in cases with confirmed bacterial infection. A combination of three lipids achieved the area under the receiver operating characteristic (ROC) curve of 0.918 (95% CI 0.835 to 1). 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.

scholarly journals Microbial and Molecular Screening of Swimmers Associated with Conjunctivitis from Public Swimming Pools in Erbil Province

2020 ◽  
Vol 31 (4) ◽  
pp. 36
Author(s):  
Sazan Q. Maulud ◽  
Lawin A. Omar ◽  
Ahmed Nawzad Hassan ◽  
Rastee H. Saeed
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Signs And Symptoms ◽  
Swimming Pool ◽  
Infection Frequency ◽  
Swimming Pools ◽  
Microbial Infection ◽  
Safe Place ◽  
Microbial Agents

Public swimming pools, if not treated well could work as a reservoir of many microorganisms that cause infections among swimmers. Conjunctivitis is one of those common infections that resulted from microbial and non-microbial agents, microbial conjunctivitis caused by viral (mainly Human adenovirus HAdVs) and bacterial infections. This study aims to investigate the prevalence of microbial causative agents of swimming pool conjunctivitis and evaluating the swimming pools in terms of health and the extent of contamination in Erbil province. Eighty-eight specimens were isolated and identified from the swimmers showing signs and symptoms of swimming pool conjunctivitis from different public swimming pools in Erbil city from January to the end of February 2020. Sample identified using bacteriological methods, serology test, and nested PCR for detection of HAdVs. The swimmers samples consisted of 60 males and 28 females, and they were aged between 16-56 years. The obtained results showed that, out of 88 samples, 36 (40.91%) detected as a viral infection and 29 (32.95%) as bacterial infection, while, 23 (26.13%) showed no growth (non-microbial infection). Frequency of swimming pool conjunctivitis among male and female was 60 (68.2%) and 28 (31.8%) respectively. Depending on the obtained results, it can be concluded that conjunctivitis could result from viral, bacterial, and non-microbial agents, a viral infection is the main cause followed by a bacterial infection, also public swimming pools are not a safe place and swimmers are subjected to infection by different pathogens.

scholarly journals Evolution of Antimicrobial Resistance in the Era of COVID-19

2021 ◽  
pp. 633-642
Author(s):  
Aditi Deepak Gupta ◽  
Praful S. Patil
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Rural Areas ◽  
Bacterial Infections ◽  
Retrospective Studies ◽  
Health Workers ◽  
Slow Growing ◽  
Resistance Tests

Antimicrobial resistance is a slow-growing phenomenon that could even be a reason for a future pandemic. Due to inappropriate diagnosis and consumption of antibiotics, the bacteria have become resistant to the antibiotics used. In the era of COVID-19, this blind consumption of antibiotics has rapidly increased due to the period of quarantine and fear of the disease. Ligue to the fear of the pandemic, especially in ru, rural areas, many patients avoid going to the hospital and consuming antibiotics without any prescription. Various retrospective studies have shown a relationship between bacterial co-infection and AMR, which is increased in the era of COVID-19. Also, the secondary bacterial infections associated with the pandemic of COVID-19 have added to the risk of antimicrobial resistance. The viral effect on the respiratory system is favorable for bacterial infection, as in the case of COVID-19 affecting the respiratory tract followed by co-bacterial infection in some cases. COVID-19 has affected AMR in many aspects. Proper antibiotic resistance tests should be performed before prescribing any antibiotics to the patient to reduce the chances of AMR, especially in such an obnoxious situation of COVID-19. This crucially calls for a brand new and effective plan of action to attenuate the influence of the pandemic on antimicrobial resistance. Statistics of various countries in matters of antimicrobial resistance have shown an increase in AMR due to the concentration of health workers, researchers, and population on the pandemic associated with COVID-19. This calls for the necessity to aware the population worldwide about antimicrobial resistance and how it could be a hidden menace in the future and could probably prove to be a matter of concern as it would worsen the condition of the patients in a particular disease and would decrease the various possible aspects of the treatment especially in case of treatment based on antibiotics.

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