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Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational studyResearch in context

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العنوان: Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational studyResearch in context
المؤلفون: Priyen Shah, Marie Voice, Leonides Calvo-Bado, Irene Rivero-Calle, Sophie Morris, Ruud Nijman, Claire Broderick, Tisham De, Irini Eleftheriou, Rachel Galassini, Aakash Khanijau, Laura Kolberg, Mojca Kolnik, Aleksandra Rudzate, Manfred G. Sagmeister, Nina A. Schweintzger, Fatou Secka, Clare Thakker, Fabian van der Velden, Clementien Vermont, Katarina Vincek, Philipp K.A. Agyeman, Aubrey J. Cunnington, Ronald De Groot, Marieke Emonts, Katy Fidler, Taco W. Kuijpers, Marine Mommert-Tripon, Karen Brengel-Pesce, Francois Mallet, Henriette Moll, Stéphane Paulus, Marko Pokorn, Andrew Pollard, Luregn J. Schlapbach, Ching-Fen Shen, Maria Tsolia, Effua Usuf, Michiel van der Flier, Ulrich von Both, Shunmay Yeung, Dace Zavadska, Werner Zenz, Victoria Wright, Enitan D. Carrol, Myrsini Kaforou, Federico Martinon-Torres, Colin Fink, Michael Levin, Jethro Herberg, Irene Rivero Calle, Manfred Sagmeister, Nina Schweintzger, Fabian Van der Velden, Taco Kuijpers, Michiel Van der Flier, Ulrich Von Both, Lucas Baumard, Evangelos Bellos, Lachlan Coin, Giselle D'Souza, Dominic Habgood-Coote, Shea Hamilton, Cllive Hoggart, Sara Hourmat, Heather Jackson, Naomi Lin, Stephanie Menikou, Samuel Nichols, Ivonne Pena Paz, Oliver Powell, Ortensia Vito, Clare Wilson, Amina Abdulla, Ladan Ali, Sarah Darnell, Rikke Jorgensen, Ian Maconochie, Sobia Mustafa, Salina Persand, Ben Walsh, Molly Stevens, Nayoung Kim, Eunjung Kim, Benjamin Pierce, Julia Dudley, Vivien Richmond, Emma Tavliavini, Ching-Chuan Liu, Shih-Min Wang, Fernando Álves González, Cristina Balo Farto, Ruth Barral-Arca, María Barreiro Castro, Xabier Bello, Mirian Ben García, Sandra Carnota, Miriam Cebey-López, María José Curras-Tuala, Carlos Durán Suárez, Luisa García Vicente, Alberto Gómez-Carballa, Jose Gómez Rial, Pilar Leboráns Iglesias, Nazareth Martinón-Torres, José María Martinón Sánchez, Belén Mosquera Pérez, Jacobo Pardo-Seco, Lidia Piñeiro Rodríguez, Sara Pischedda, Sara Ray Vázquez, Carmen Rodríguez-Tenreiro, Lorenzo Redondo-Collazo, Miguel Sadiki Ora, Antonio Sallas, Sonia Serén Fernández, Cristina Serén Trasorras, Marisol Vilas Iglesias, Anda Balode, Arta Bãrdzdina, Dãrta Deksne, Dace Gardovska, Dagne Grãvele, Ilze Grope, Anija Meiere, Ieve Nokalna, Jana Pavãre, Zanda Pučuka, Katrīna Selecka, Dace Svile, Urzula Nora Urbãne, Kalifa Bojang, Syed M.A. Zaman, Suzanne Anderson, Anna Roca, Isatou Sarr, Momodou Saidykhan, Saffiatou Darboe, Samba Ceesay, Umberto D'alessandro, Dorine M. Borensztajn, Nienke N. Hagedoorn, Chantal Tal, Joany Zachariasse, W. Dik, Christoph Aebi, Christoph Berger, Verena Wyss, Mariama Usman, Eric Giannoni, Martin Stocker, Klara M. Posfay-Barbe, Ulrich Heininger, Sara Bernhard-Stirnemann, Anita Niederer-Loher, Christian Kahlert, Giancarlo Natalucci, Christa Relly, Thomas Riedel, Elizabeth Cocklin, Rebecca Jennings, Joanne Johnson, Simon Leigh, Karen Newall, Sam Romaine, Maria Tambouratzi, Antonis Marmarinos, Marietta Xagorari, Kelly Syggelou, Nikos Spyridis, Jennifer Blackmore, Rebekah Harrison, Benno Kohlmaier, Daniela S. Kohlfürst, Christoph Zurl, Alexander Binder, Susanne Hösele, Manuel Leitner, Lena Pölz, Glorija Rajic, Sebastian Bauchinger, Hinrich Baumgart, Martin Benesch, Astrid Ceolotto, Ernst Eber, Siegfried Gallisti, Gunther Gores, Harald Haidl, Almuthe Hauer, Christa Hude, Markus Keldorfer, Larissa Krenn, Heidemarie Pilch, Andreas Pfleger, Klaus Pfurtscheller, Gudrun Nordberg, Tobias Niedrist, Siegfried Rödl, Andrea Skrabl-Baumgartner, Matthias Sperl, Laura Stampfer, Volker Strenger, Holger Till, Andreas Trobisch, Sabine Löffler, Juan Emmanuel Dewez, Martin Hibberd, David Bath, Alec Miners, Elizabeth Fitchett, Catherine Wedderburn, Anne Meierford, Baptiste Leurent, Marien I. De Jonge, Koen van Aerde, Wynand Alkema, Bryan van den Broek, Jolein Gloerich, Alain J. Van Gool, Stefanie Henriet, Martijn Huijnen, Ria Philipsen, Esther Willems, G.P.J.M. Gerrits, M. Van Leur, J. Heidema, L. De Haan, C.J. Miedema, C. Neeleman, C.C. Obihara, G.A. Tramper-Stranders, Rama Kandasamy, Michael J. Carter, Daniel O'Connor, Sagida Bibi, Dominic F. Kelly, Meeru Gurung, Stephen Throson, Imran Ansari, David R. Murdoch, Shrijana Shrestha, Zoe Oliver, Emma Lim, Lucille Valentine, Karen Allen, Kathryn Bell, Adora Chan, Stephen Crulley, Kirsty Devine, Daniel Fabian, Sharon King, Paul McAlinden, Sam McDonald, Anne McDonell, Alisa Pickering, Evelyn Thomson, Amanda Wood, Diane Wallia, Phil Woodsford, Frances Baxter, Ashley Bell, Mathew Rhodes, Rachel Agbeko, Christine Mackerness, Bryan Baas, Lieke Kloosterhuis, Wilma Oosthoek, Tasnim Arif, Joshua Bennet, Kalvin Collings, Ilona Van der Giessen, Alex Martin, Aqeela Rashid, Emily Rowlands, Joshua Soon, Gabriella De Vries, Mike Martin, Ravi Mistry, Manuela Zwerenz, Judith Buschbeck, Christoph Bidlingmaier, Vera Binder, Katharina Danhauser, Nikolaus Haas, Matthias Griese, Matthias Kappler, Eberhard Lurz, Georg Muench, Karl Reiter, Carola Schoen, Alexandre Pachot, Marine Mommert, Tina Plankar Srovin, Natalija Bahovec, Petra Prunk, Veronika Osterman, Tanja Avramoska, Ilse Jongerius, J.M. van den Berg, D. Schonenberg, A.M. Barendregt, D. Pajkrt, M. van der Kuip, A.M. van Furth, Evelien Sprenkeler, Judith Zandstra, G. van Mierlo, J. Geissler
المصدر: The Lancet Regional Health. Europe, Vol 32, Iss , Pp 100682- (2023)
بيانات النشر: Elsevier
سنة النشر: 2023
المجموعة: Directory of Open Access Journals: DOAJ Articles
مصطلحات موضوعية: Molecular diagnostics, Diagnostic, Febrile illness, Infectious disease, Bacterial, Viral, Public aspects of medicine, RA1-1270
الوصف: Summary: 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. ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
تدمد: 2666-7762
العلاقة: http://www.sciencedirect.com/science/article/pii/S2666776223001011Test; https://doaj.org/toc/2666-7762Test; https://doaj.org/article/385b84aa34944e70970397e2518aaf4fTest
DOI: 10.1016/j.lanepe.2023.100682
الإتاحة: https://doi.org/10.1016/j.lanepe.2023.100682Test
https://doaj.org/article/385b84aa34944e70970397e2518aaf4fTest
رقم الانضمام: edsbas.2F271F32
قاعدة البيانات: BASE
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Agbeko</searchLink><br /><searchLink fieldCode="AR" term="%22Christine+Mackerness%22">Christine Mackerness</searchLink><br /><searchLink fieldCode="AR" term="%22Bryan+Baas%22">Bryan Baas</searchLink><br /><searchLink fieldCode="AR" term="%22Lieke+Kloosterhuis%22">Lieke Kloosterhuis</searchLink><br /><searchLink fieldCode="AR" term="%22Wilma+Oosthoek%22">Wilma Oosthoek</searchLink><br /><searchLink fieldCode="AR" term="%22Tasnim+Arif%22">Tasnim Arif</searchLink><br /><searchLink fieldCode="AR" term="%22Joshua+Bennet%22">Joshua Bennet</searchLink><br /><searchLink fieldCode="AR" term="%22Kalvin+Collings%22">Kalvin Collings</searchLink><br /><searchLink fieldCode="AR" term="%22Ilona+Van+der+Giessen%22">Ilona Van der Giessen</searchLink><br /><searchLink fieldCode="AR" term="%22Alex+Martin%22">Alex Martin</searchLink><br /><searchLink fieldCode="AR" term="%22Aqeela+Rashid%22">Aqeela Rashid</searchLink><br /><searchLink fieldCode="AR" term="%22Emily+Rowlands%22">Emily Rowlands</searchLink><br /><searchLink fieldCode="AR" term="%22Joshua+Soon%22">Joshua Soon</searchLink><br /><searchLink fieldCode="AR" term="%22Gabriella+De+Vries%22">Gabriella De Vries</searchLink><br /><searchLink fieldCode="AR" term="%22Mike+Martin%22">Mike Martin</searchLink><br /><searchLink fieldCode="AR" term="%22Ravi+Mistry%22">Ravi Mistry</searchLink><br /><searchLink fieldCode="AR" term="%22Manuela+Zwerenz%22">Manuela Zwerenz</searchLink><br /><searchLink fieldCode="AR" term="%22Judith+Buschbeck%22">Judith Buschbeck</searchLink><br /><searchLink fieldCode="AR" term="%22Christoph+Bidlingmaier%22">Christoph Bidlingmaier</searchLink><br /><searchLink fieldCode="AR" term="%22Vera+Binder%22">Vera Binder</searchLink><br /><searchLink fieldCode="AR" term="%22Katharina+Danhauser%22">Katharina Danhauser</searchLink><br /><searchLink fieldCode="AR" term="%22Nikolaus+Haas%22">Nikolaus Haas</searchLink><br /><searchLink fieldCode="AR" term="%22Matthias+Griese%22">Matthias Griese</searchLink><br /><searchLink fieldCode="AR" term="%22Matthias+Kappler%22">Matthias Kappler</searchLink><br /><searchLink fieldCode="AR" term="%22Eberhard+Lurz%22">Eberhard Lurz</searchLink><br /><searchLink fieldCode="AR" term="%22Georg+Muench%22">Georg Muench</searchLink><br /><searchLink fieldCode="AR" term="%22Karl+Reiter%22">Karl Reiter</searchLink><br /><searchLink fieldCode="AR" term="%22Carola+Schoen%22">Carola Schoen</searchLink><br /><searchLink fieldCode="AR" term="%22Alexandre+Pachot%22">Alexandre Pachot</searchLink><br /><searchLink fieldCode="AR" term="%22Marine+Mommert%22">Marine Mommert</searchLink><br /><searchLink fieldCode="AR" term="%22Tina+Plankar+Srovin%22">Tina Plankar Srovin</searchLink><br /><searchLink fieldCode="AR" term="%22Natalija+Bahovec%22">Natalija Bahovec</searchLink><br /><searchLink fieldCode="AR" term="%22Petra+Prunk%22">Petra Prunk</searchLink><br /><searchLink fieldCode="AR" term="%22Veronika+Osterman%22">Veronika Osterman</searchLink><br 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Schonenberg</searchLink><br /><searchLink fieldCode="AR" term="%22A%2EM%2E+Barendregt%22">A.M. Barendregt</searchLink><br /><searchLink fieldCode="AR" term="%22D%2E+Pajkrt%22">D. Pajkrt</searchLink><br /><searchLink fieldCode="AR" term="%22M%2E+van+der+Kuip%22">M. van der Kuip</searchLink><br /><searchLink fieldCode="AR" term="%22A%2EM%2E+van+Furth%22">A.M. van Furth</searchLink><br /><searchLink fieldCode="AR" term="%22Evelien+Sprenkeler%22">Evelien Sprenkeler</searchLink><br /><searchLink fieldCode="AR" term="%22Judith+Zandstra%22">Judith Zandstra</searchLink><br /><searchLink fieldCode="AR" term="%22G%2E+van+Mierlo%22">G. van Mierlo</searchLink><br /><searchLink fieldCode="AR" term="%22J%2E+Geissler%22">J. Geissler</searchLink> )
Array ( [Name] => TitleSource [Label] => Source [Group] => Src [Data] => The Lancet Regional Health. Europe, Vol 32, Iss , Pp 100682- (2023) )
Array ( [Name] => Publisher [Label] => Publisher Information [Group] => PubInfo [Data] => Elsevier )
Array ( [Name] => DatePubCY [Label] => Publication Year [Group] => Date [Data] => 2023 )
Array ( [Name] => Subset [Label] => Collection [Group] => HoldingsInfo [Data] => Directory of Open Access Journals: DOAJ Articles )
Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => <searchLink fieldCode="DE" term="%22Molecular+diagnostics%22">Molecular diagnostics</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic%22">Diagnostic</searchLink><br /><searchLink fieldCode="DE" term="%22Febrile+illness%22">Febrile illness</searchLink><br /><searchLink fieldCode="DE" term="%22Infectious+disease%22">Infectious disease</searchLink><br /><searchLink fieldCode="DE" term="%22Bacterial%22">Bacterial</searchLink><br /><searchLink fieldCode="DE" term="%22Viral%22">Viral</searchLink><br /><searchLink fieldCode="DE" term="%22Public+aspects+of+medicine%22">Public aspects of medicine</searchLink><br /><searchLink fieldCode="DE" term="%22RA1-1270%22">RA1-1270</searchLink> )
Array ( [Name] => Abstract [Label] => Description [Group] => Ab [Data] => Summary: 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. ... )
Array ( [Name] => TypeDocument [Label] => Document Type [Group] => TypDoc [Data] => article in journal/newspaper )
Array ( [Name] => Language [Label] => Language [Group] => Lang [Data] => English )
Array ( [Name] => ISSN [Label] => ISSN [Group] => ISSN [Data] => 2666-7762 )
Array ( [Name] => NoteTitleSource [Label] => Relation [Group] => SrcInfo [Data] => http://www.sciencedirect.com/science/article/pii/S2666776223001011; https://doaj.org/toc/2666-7762; https://doaj.org/article/385b84aa34944e70970397e2518aaf4f )
Array ( [Name] => DOI [Label] => DOI [Group] => ID [Data] => 10.1016/j.lanepe.2023.100682 )
Array ( [Name] => URL [Label] => Availability [Group] => URL [Data] => https://doi.org/10.1016/j.lanepe.2023.100682<br />https://doaj.org/article/385b84aa34944e70970397e2518aaf4f )
Array ( [Name] => AN [Label] => Accession Number [Group] => ID [Data] => edsbas.2F271F32 )
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Geissler ) ) ) ) [IsPartOfRelationships] => Array ( [0] => Array ( [BibEntity] => Array ( [Dates] => Array ( [0] => Array ( [D] => 01 [M] => 01 [Type] => published [Y] => 2023 ) ) [Identifiers] => Array ( [0] => Array ( [Type] => issn-print [Value] => 26667762 ) [1] => Array ( [Type] => issn-locals [Value] => edsbas ) [2] => Array ( [Type] => issn-locals [Value] => edsbas.oa ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => The Lancet Regional Health. Europe, Vol 32, Iss , Pp 100682- (2023 [Type] => main ) ) ) ) ) ) )
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