鼻中的宿主基因表达可以区分微生物学证实的病毒和细菌下呼吸道感染
L Gayani Tillekeratne1,2,3,4, Nicholas O'Grady1, Maria D Iglesias-Ussel1,4
1Duke University School of Medicine, Durham, NC, USA.
Journal of clinical and translational science
|January 7, 2026
概括
区分病毒和细菌下呼吸道感染 (LRTI) 是至关重要的. 一种新的鼻拭片试验使用宿主基因表达精确地识别了LRTI的原因,优于以前的基于血液的方法.
科学领域:
- 传染性疾病 传染性疾病
- 分子诊断学 分子诊断学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 区分病毒和细菌下呼吸道感染 (LRTI) 是一个临床挑战.
- 以前的研究开发了一种基于宿主反应的测定方法,使用外周血液来区分病毒和细菌感染.
研究的目的:
- 为了评估基于宿主反应的测试的性能,使用鼻 (NP) 样本来区分病毒与细菌LRTI.
- 开发和验证NP样本的新型预测模型.
主要方法:
- 基于宿主反应的测定 (Biomeme HR-B/V) 评估了24个基因标,应用于来自LRTI患者的NP抽样样本.
- 评估了先前分类器的性能,并为NP样本生成了一个新的预测模型.
- 使用外部数据集与鼻腔/NP RNA 序列数据验证了结果.
主要成果:
- 新型模型表现出更好的性能,受体操作员曲线 (AUC) 下的面积为0.881的细菌感染.
- 准确度达到0.84,阳性百分比协议 (PPA) 为0.86和阴性百分比协议 (NPA) 为0.83的细菌感染.
- 在两个数据集的外部验证中,高AUC值为0.932和0.915.
结论:
- 鼻样本中的宿主反应基因表达可以有效地区分病毒和细菌LRTI.
- 这些发现表明LRTI病因学的有希望的诊断方法.
- 建议在更大,更多样化的队列中进一步验证.
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