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Optimal combination of early biomarkers for infection and sepsis diagnosis in the emergency department: The BIPS study

Abstract : Objective: To define the best combination of biomarkers for the diagnosis of infection and sepsis in the emergency room. Methods: In this prospective study, consecutive patients with a suspicion of infection in the emergency room were included. Eighteen different biomarkers measured in plasma, and twelve biomarkers measured on monocytes, neutrophils, B and T-lymphocytes were studied and the best combinations determined by a gradient tree boosting approach. Results: Overall, 291 patients were included and analysed, 148 with bacterial infection, and 47 with viral infection. The best biomarker combination which first allowed the diagnosis of bacterial infection, included HLA-DR (human leukocyte antigen DR) on monocytes, MerTk (Myeloid-epithelial-reproductive tyrosine kinase) on neutrophils and plasma metaloproteinase-8 (MMP8) with an area under the curve (AUC) = 0.94 [95% confidence interval (IC95): 0.91;0.97]. Among patients in whom a bacterial infection was excluded, the combination of CD64 expression, and CD24 on neutrophils and CX3CR1 on monocytes ended to an AUC = 0.98 [0.96;1] to define those with a viral infection. Conclusion: In a convenient cohort of patients admitted with a suspicion of infection, two different combinations of plasma and cell surface biomarkers were performant to identify bacterial and viral infection.
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https://hal-univ-paris.archives-ouvertes.fr/hal-03254428
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Submitted on : Tuesday, June 8, 2021 - 5:56:06 PM
Last modification on : Tuesday, July 13, 2021 - 3:29:30 AM

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Laetitia Velly, Steven Volant, Catherine Fitting, Daniel Aiham Ghazali, Florian Salipante, et al.. Optimal combination of early biomarkers for infection and sepsis diagnosis in the emergency department: The BIPS study. Journal of Infection, WB Saunders, 2021, 82 (4), pp.11-21. ⟨10.1016/j.jinf.2021.02.019⟩. ⟨hal-03254428⟩

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