Genetic tests could soon help doctors distinguish between bacterial and viral infections in children with fever, according to a new study.
Certain genes are only switched on only when a child is suffering from a bacterial infection, allowing a gene test to determine infections to be caught and treated more rapidly, the researchers say.
This is the finding of a study by an international team of scientists, led by researchers at Imperial College London, UK.
Professor Michael Levin and colleagues explain that differentiating between viruses and bacteria is crucially important, but there is currently no quick method for testing this when a child arrives at a surgery or hospital with fever.
Bacterial infections are far more dangerous, and can lead to meningitis, septicaemia or pneumonia. So the team looked at the medical records of 240 children aged 19 months on average, who arrived at hospitals with fever in the UK, Spain, the Netherlands and the USA.
Viral or bacterial infection was diagnosed using traditional methods, and the genes in their white blood cells were also tested using RNA micro arrays.
This identified two genes that are only switched on in bacterial infections. These genes, IFI44L and FAM89A, predicted a bacterial infection with 95% to 100% accuracy, the team reports in yesterday’s (23 August) Journal of the American Medical Association.
The authors hope that a test for the activity of these genes could prevent children with viral infections being unnecessarily prescribed antibiotics, which are only effective against bacteria. This would help combat the growing threat of antibiotic resistance.
Professor Levin says: "Every year many children are sent away from emergency departments or doctors’ surgeries because the medical team thinks they have a viral infection, when in fact they are suffering from life-threatening bacterial infections.
"Conversely, many other children receive antibiotics because the medical team are unable to immediately exclude the possibility of a bacterial infection – but in fact they are suffering from a virus."
Herberg, J. A. et al. Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children. Journal of the American Medical Association 23 August 2016 doi:10.1001/jama.2016.11236
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