Combinatorial host-response biomarker signature (BV score) and its subanalytes TRAIL, IP-10, and CRP in children with Mycoplasma pneumoniae community-acquired pneumonia
Cihan Papan, Semjon Sidorov, Beat Greiter, Nina Bühler, Christoph Berger, Sören L Becker, Patrick M Meyer Sauteur- Infectious Diseases
- Immunology and Allergy
Abstract
Background
Host-response biomarkers to differentiate bacterial from viral etiology in children with respiratory infections have shown high accuracies, but are understudied in Mycoplasma pneumoniae (Mp) infections.
Methods
We compared BV scores (0-34 indicating viral, and 66-100 indicating bacterial etiology), TRAIL (pg/mL), IP-10 (pg/mL), and CRP (mg/L) serum levels between Mp positive (Mp+) and negative (Mp-) community-acquired pneumonia (CAP). We performed receiver operating characteristic (ROC) curve analyses for clinical features and biomarkers.
Results
Of 80 CAP patients (median age 6.3 years, 57.5% male), 26 were Mp + CAP. By comparing Mp + CAP with Mp–CAP patients, BV scores were lower (median 14.0, IQR 3.0–27.8 vs. 54.0, IQR 12.0–84.8; P = 0.0008), TRAIL levels were higher (86.5, IQR 67.4–123.0 vs. 65.5, IQR 42.5–103.9; P = 0.025), CRP levels were lower (12.9, IQR 4.0–22.3 vs. 36.7, IQR 13.0–132.8; P = 0.0019), and IP-10 levels were comparable (366.0, IQR 150.2–603.8 vs. 331.0, IQR 154.3–878.8; P = 0.73). ROC analyses yielded a comparable discriminatory accuracy for the combination of age, fever duration, respiratory symptoms duration, with either procalcitonin or BV (AUC 0.87 vs. 0.86, P = 0.94).
Conclusions
Children with Mp + CAP have atypically low, viral levels of the BV score, underscoring the complementary role of microbiological testing.