Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Shah, PY; Voice, M; Calvo-Bado, L; Rivero-Calle, I; Morris, S; Nijman, R; Broderick, C; De, TS; Eleftheriou, I; Galassini, R; Khanijau, A; Kolberg, L; Kolnik, M; Rudzate, A; Sagmeister, MG; Schweintzger, NA; Secka, F; Thakker, C; van der Velden, FV; Vermont, C; Vincek, K; Agyeman, PKA; Cunnington, AJ; De Groot, R; Emonts, M; Fidler, K; Kuijpers, TW; Mommert-Tripon, M; Brengel-Pesce, K; Mallet, F; Moll, H; Paulus, S; Pokorn, M; Pollard, A; Schlapbach, LJ; Shen, CF; Tsolia, M; Usuf, E; van der Flier, M; von Both, U; Yeung, SM; Zavadska, D; Zenz, W; Wright, V; Carrol, ED; Kaforou, M; Martinon-Torres, F; Fink, C; Levin, M; Herberg, J.
Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational study
LANCET REG HEALTH-EU. 2023; 32: 100707
Doi: 10.1016/j.lanepe.2023.100707
Web of Science
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Sagmeister Manfred Gerald
- Schweintzger Nina
- Zenz Werner
- Study Group Mitglieder der Med Uni Graz:
- Bauchinger Sebastian
- Baumgart Hinrich
- Benesch Martin
- Binder Alexander
- Eber Ernst
- Gallistl Siegfried
- Gores Gunther
- Haidl Harald
- Hauer Almuthe
- Keldorfer Markus
- Kohlfürst Daniela
- Kohlmaier Benno
- Krenn Larissa
- Leitner Manuel
- Löffler Sabine
- Niedrist Tobias Josef
- Nordberg Gudrun
- Pfleger Andreas
- Pfurtscheller Klaus
- Pilch Heidemarie
- Pölz Lena
- Rajic Glorija
- Roedl Siegfried
- Skrabl-Baumgartner Andrea
- Sperl Matthias
- Stampfer Laura
- Strenger Volker
- Till Holger
- Trobisch Andreas
- Zurl Christoph Johann
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Background The PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice.Methods Febrile children and controls were recruited on presentation to hospital in 9 European countries 2016-2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data. Subsequently, centralised molecular tests (CMTs) for 19 respiratory and 27 blood pathogens were performed.Findings Of 4611 febrile children, 643 (14%) were classified as definite bacterial infection (DB), 491 (11%) as definite viral infection (DV), and 3477 (75%) had uncertain aetiology. 1061 controls without infection were recruited. CMTs detected blood bacteria more frequently in DB than DV cases for N. meningitidis (OR: 3.37, 95% CI: 1.92-5.99), S. pneumoniae (OR: 3.89, 95% CI: 2.07-7.59), Group A streptococcus (OR 2.73, 95% CI 1.13-6.09) and E. coli (OR 2.7, 95% CI 1.02-6.71). Respiratory viruses were more common in febrile children than controls, but only influenza A (OR 0.24, 95% CI 0.11-0.46), influenza B (OR 0.12, 95% CI 0.02-0.37) and RSV (OR 0.16, 95% CI: 0.06-0.36) were less common in DB than DV cases. Of 16 blood viruses, enterovirus (OR 0.43, 95% CI 0.23-0.72) and EBV (OR 0.71, 95% CI 0.56-0.90) were detected less often in DB than DV cases. Combined local diagnostics and CMTs respectively detected blood viruses and respiratory viruses in 360 (56%) and 161 (25%) of DB cases, and virus detection ruled-out bacterial infection poorly, with predictive values of 0.64 and 0.68 respectively.Interpretation Most febrile children cannot be conclusively defined as having bacterial or viral infection when molecular tests supplement conventional approaches. Viruses are detected in most patients with bacterial infections, and the clinical value of individual pathogen detection in determining treatment is low. New approaches are needed to help determine which febrile children require antibiotics.Funding EU Horizon 2020 grant 668303. Copyright & COPY; 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Find related publications in this database (Keywords)
- Molecular diagnostics
- Diagnostic
- Febrile illness
- Infectious disease
- Bacterial
- Viral
- Respiratory infection