Detection of Viral Infection and Bacterial Coinfection and Superinfection in Coronavirus Disease 2019 Patients Presenting to the Emergency Department Using the 29-mRNA Host Response Classifier IMX-BVN-3: A Multicenter Study.

Bauer, Wolfgang; Gläser, Sven; Thiemig, Dorina; Wanner, Katrin; Peric, Alexander; Behrens, Steffen; Bialas, Johanna; Behrens, Angelika; Galtung, Noa; Liesenfeld, Oliver; Sun, Lisa; May, Larissa; Mace, Sharron; Ott, Sebastian; Vesenbeckh, Silvan (2022). Detection of Viral Infection and Bacterial Coinfection and Superinfection in Coronavirus Disease 2019 Patients Presenting to the Emergency Department Using the 29-mRNA Host Response Classifier IMX-BVN-3: A Multicenter Study. Open Forum Infectious Diseases, 9(9), ofac437. Oxford University Press 10.1093/ofid/ofac437

[img]
Preview
Text
ofac437.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (514kB) | Preview

Background

Identification of bacterial coinfection in patients with coronavirus disease 2019 (COVID-19) facilitates appropriate initiation or withholding of antibiotics. The Inflammatix Bacterial Viral Noninfected (IMX-BVN) classifier determines the likelihood of bacterial and viral infections. In a multicenter study, we investigated whether IMX-BVN version 3 (IMX-BVN-3) identifies patients with COVID-19 and bacterial coinfections or superinfections.

Methods

Patients with polymerase chain reaction-confirmed COVID-19 were enrolled in Berlin, Germany; Basel, Switzerland; and Cleveland, Ohio upon emergency department or hospital admission. PAXgene Blood RNA was extracted and 29 host mRNAs were quantified. IMX-BVN-3 categorized patients into very unlikely, unlikely, possible, and very likely bacterial and viral interpretation bands. IMX-BVN-3 results were compared with clinically adjudicated infection status.

Results

IMX-BVN-3 categorized 102 of 111 (91.9%) COVID-19 patients into very likely or possible, 7 (6.3%) into unlikely, and 2 (1.8%) into very unlikely viral bands. Approximately 94% of patients had IMX-BVN-3 unlikely or very unlikely bacterial results. Among 7 (6.3%) patients with possible (n = 4) or very likely (n = 3) bacterial results, 6 (85.7%) had clinically adjudicated bacterial coinfection or superinfection. Overall, 19 of 111 subjects for whom adjudication was performed had a bacterial infection; 7 of these showed a very likely or likely bacterial result in IMX-BVN-3.

Conclusions

IMX-BVN-3 identified COVID-19 patients as virally infected and identified bacterial coinfections and superinfections. Future studies will determine whether a point-of-care version of the classifier may improve the management of COVID-19 patients, including appropriate antibiotic use.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Ott, Sebastian Robert

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2328-8957

Publisher:

Oxford University Press

Language:

English

Submitter:

Pubmed Import

Date Deposited:

21 Sep 2022 09:09

Last Modified:

30 May 2023 13:18

Publisher DOI:

10.1093/ofid/ofac437

PubMed ID:

36111173

Uncontrolled Keywords:

COVID-19 PCR SARS-CoV-2 bacterial infection coinfection superinfection viral infection

BORIS DOI:

10.48350/173043

URI:

https://boris.unibe.ch/id/eprint/173043

Actions (login required)

Edit item Edit item
Provide Feedback