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Updated: Oct 10, 2025
High-Throughput Transcriptome Analysis for Investigating Host-Pathogen Interactions
Published on: March 5, 2022
Transcript host-RNA signatures to discriminate bacterial and viral infections in febrile children
Danilo Buonsenso1,2,3,4, Giorgio Sodero5, Piero Valentini6,7,5
1Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy. danilobuonsenso@gmail.com.
Insights
Transcript host-RNA signatures offer a promising new method to differentiate viral and bacterial infections in children. This approach can improve diagnosis, optimize antibiotic use, and reduce resistance.
Area of Science:
- Pediatric infectious diseases
- Molecular diagnostics
- Host-pathogen interactions
Background:
- Traditional markers like white blood cell count, C-reactive protein, and procalcitonin are insufficient for distinguishing viral from bacterial infections in children.
- This diagnostic gap leads to delayed recognition of serious infections like sepsis and overuse of antibiotics, contributing to resistance and impacting pediatric microbiota.
- Accurate differentiation is crucial for timely and appropriate management, especially in vulnerable populations such as infants and neutropenic patients.
Purpose of the Study:
- To systematically review the efficacy and application of transcript host-RNA signatures for differentiating viral and bacterial infections in febrile children.
- To identify challenges associated with the implementation of this novel diagnostic method.
- To assess the potential impact of RNA signatures on clinical decision-making regarding antibiotic therapy.
Main Methods:
- Systematic review of studies evaluating transcript host-RNA signatures in febrile children.
- Analysis of RNA transcriptional biosignatures in host leukocytes to differentiate infection types.
- Evaluation of diagnostic accuracy and clinical utility compared to traditional markers.
Main Results:
- Growing evidence supports the ability of transcript host-RNA signatures to better characterize the spectrum of bacterial and viral infections.
- These signatures show potential for optimizing antibiotic use in pediatric populations.
- The review identified significant variability in target populations and diagnostic standards across studies, limiting generalizability.
Conclusions:
- Transcript host-RNA signatures represent a novel tool that can enhance the characterization of infectious and inflammatory illnesses in febrile children.
- Integration with traditional methods may improve the judicious use of antibiotic therapy.
- Further standardization and validation are needed to overcome implementation challenges and generalize findings.
Abstract:
Traditional laboratory markers, such as white blood cell count, C-reactive protein, and procalcitonin, failed to discriminate viral and bacterial infections in children. The lack of an accurate diagnostic test has a negative impact on child's care, limiting the ability of early diagnosis and appropriate management of children. This, on the one hand, may lead to delayed recognition of sepsis and severe bacterial infections, which still represent the leading causes of child morbidity and mortality. On the other hand, this may lead to overuse of empiric antibiotic therapies, particularly for specific subgroups of patients, such as infants younger than 90 days of life or neutropenic patients. This approach has an adverse effect on costs, antibiotic resistance, and pediatric microbiota. Transcript host-RNA signatures are a new tool used to differentiate viral from bacterial infections by analyzing the transcriptional biosignatures of RNA in host leukocytes. In this systematic review, we evaluate the efficacy and the possible application of this new diagnostic method in febrile children, along with challenges in its implementation. Our review support the growing evidence that the application of these new tools can improve the characterization of the spectrum of bacterial and viral infections and optimize the use of antibiotics in children. IMPACT: Transcript host RNA signatures may allow to better characterize the spectrum of viral, bacterial, and inflammatory illnesses in febrile children and can be used with traditional diagnostic methods to determine if and when to start antibiotic therapy. This is the first review on the use of transcript RNA signatures in febrile children to distinguish viral from bacterial infections. Our review identified a wide variability of target populations and gold standards used to define sepsis and SBIs, limiting the generalization of our findings.
