Methods: In the prospective multinational multicenter study “AutoPilot-Dx” (NCT03052088) we aim to validate the diagnostic accuracy of the ImmunoXpert™ test. Infection etiology was assigned by majority adjudication of three experts based on comprehensive clinical and laboratory investigation. Viruses were detected using multiplex-PCR applied to nasopharyngeal swabs (Allplex™, Seegene). We performed an interim analysis of the first 134 febrile children recruited that had both PCR viral detection and etiology determination. TRAIL, IP-10, CRP and ImmunoXpert™ values were measured via a Tecan EVO75 ELISA platform.
Results: Bacterial diagnoses were assigned by the experts to 29%, 29% and 25% of patients with adenovirus (ADV), rhinovirus (RV), and respiratory syncytial virus (RSV) detection, respectively. Children with a viral infection including ADV, RSV, and RV had significantly lower ImmunoXpert™ scores as compared to children with a bacterial infection. Notably, TRAIL levels were markedly increased in viral infections as compared to bacterial infection, irrespective of the detected virus.
Conclusion: Classification of viral infections correlated significantly with elevated TRAIL levels and low ImmunoXpert™ scores. The differential expression of TRAIL in response to viral versus bacterial infections can complement molecular viral detection, appears useful in the diagnostic workup for febrile children and may reduce antibiotic misuse.
M. Porwoll, None
U. Hakim, None
A. Argentiero, None
I. Testa, None
M. B. Pasticci, None
D. Mezzetti, None
K. Perruccio, None
L. Etshtein, MeMed Diagnostics: Employee , Salary .
N. Mastboim, MeMed Diagnostics: Employee , Salary .
A. Cohen, MeMed Diagnostics: Employee , Salary .
E. Simon, MeMed: Employee , Salary .
O. Boico, MeMed Diagnostics: Employee , Salary .
L. Shani, MeMed Diagnostics: Employee , Salary .
T. Gottlieb, MeMed Diagnostics: Employee , Salary .
R. Navon, MeMed Diagnostics: Employee , Salary .
K. Oved, MeMed Diagnostics: Board Member , Employee and Shareholder , Salary .
E. Eden, MeMed Diagnostics: Board Member , Employee and Shareholder , Salary .
A. Simon, None
J. Liese, None
M. Knuf, None
S. Schneider, None
E. Farinelli, None
S. Esposito, None