Plasma lipid profiles discriminate bacterial from viral infection in febrile children
Authors: Wang Xinzhu , Nijman Ruud , Camuzeaux Stephane , Sands Caroline , Jackson Heather , Kaforou Myrsini , Emonts Marieke , Herberg Jethro A. , Maconochie Ian , Carrol Enitan D. , Paulus Stephane C. , Zenz Werner , Van der Flier Michiel , de Groot Ronald , Martinon-Torres Federico , Schlapbach Luregn J. , Pollard Andrew J. , Fink Colin , Kuijpers Taco T. , Anderson Suzanne , Lewis Matthew R. , Levin Michael , McClure Myra ,   EUCLIDS consortium, Gormley Stuart , Hamilton Shea , Hourmat Bernardo , Hoggart Clive , Sancho-Shimizu Vanessa , Wright Victoria , Abdulla Amina , Agapow Paul , Bartlett Maeve , Bellos Evangelos , Eleftherohorinou Hariklia , Galassini Rachel , Inwald David , Mashbat Meg , Menikou Stefanie , Mustafa Sobia , Nadel Simon , Rahman Rahmeen , Thakker Clare , Coin Lachlan M. J. , Bokhandi S. , Power Sue , Barham Heather , Pathan Dr N , Ridout Jenna , White Deborah , Thurston Sarah , Faust S. , Patel S. , McCorkell Jenni , Davies P. , Crate Lindsey , Navarra Helen , Carter Stephanie , Ramaiah R. , Patel Rekha , Tuffrey Catherine , Gribbin Andrew , McCready Sharon , Peters Mark , Hardy Katie , Standing Fran , O’Neill Lauren , Abelake Eugenia , Deep Akash , Nsirim Eniola , Willis Louise , Young Zoe , Royad C. , White Sonia , Fortune P. M. , Hudnott Phil , González Fernando Álvez , Barral-Arca Ruth , Cebey-López Miriam , Curras-Tuala María José , García Natalia , Vicente Luisa García , Gómez-Carballa Alberto , Rial Jose Gómez , Beiroa Andrea Grela , Grande Antonio Justicia , Iglesias Pilar Leboráns , Santos Alba Elena Martínez , Martinón-Torres Federico , MartinónTorres Nazareth , Sánchez José María Martinón , Gutiérrez Beatriz Morillo , Pérez Belén Mosquera , Pacheco Pablo Obando , Pardo-Seco Jacobo , Pischedda Sara , RiveroCalle Irene , Rodríguez-Tenreiro Carmen , Redondo-Collazo Lorenzo , Ellacuriagal Antonio Salas , Fernández Sonia Serén , Silva María del Sol Porto , Vega Ana , Trillo Lucía Vilanova , Salas Antonio , Reyes Susana Beatriz , León María Cruz León , Mingorance Álvaro Navarro , Barrios Xavier Gabaldó , Vergara Eider Oñate , Torre Andrés Concha , Vivanco Ana , Fernández Reyes , Sánchez Francisco Giménez , Forte Miguel Sánchez , Rojo Pablo , Contreras J. Ruiz , Palacios Alba , Ibarrondo Cristina Epalza , Cooke Elizabeth Fernández , Navarro Marisa , Álvarez Cristina Álvarez , Lozano María José , Carreras Eduardo , Sanagustín Sonia Brió , Neth Olaf , Padilla Ma del Carmen Martínez , Tato Luis Manuel Prieto , Guillén Sara , Silveira Laura Fernández , Moreno David , van Furth A. M. Tutu , Boeddha N. P. , Driessen G. J. A. , Emonts M. , Hazelzet J. A. , Pajkrt D. , Sanders E. A. M. , van de Beek D. , van der Ende A. , Philipsen H. L. A. , Adeel A. O. A. , Breukels M. A. , Brinkman D. M. C. , de Korte C. C. M. M. , de Vries E. , de Waal W. J. , Dekkers R. , Dings-Lammertink A. , Doedens R. A. , Donker A. E. , Dousma M. , Faber T. E. , Gerrits G. P. J. M. , Gerver J. A. M. , Heidema J. , Veen J. Homan-van der , Jacobs M. A. M. , Jansen N. J. G. , Kawczynski P. , Klucovska K. , Kneyber M. C. J. , Koopman-Keemink Y. , Langenhorst V. J. , Leusink J. , Loza B. F. , Merth I. T. , Miedema C. J. , Neeleman C. , Noordzij J. G. , Obihara C. C. , van Overbeek – van Gils A. L. T. , Poortman G. H. , Potgieter S. T. , Potjewijd J. , Rosias P. P. R. , Sprong T. , ten Tussher G. W. , Thio B. J. , Tramper-Stranders G. A. , van Deuren M. , van der Meer H. , van Kuppevelt A. J. M. , van Wermeskerken A. M. , Verwijs W. A. , Wolfs T. F. W. , Agyeman Philipp , Aebi Christoph , Berger Christoph , Agyeman Philipp , Aebi Christoph , Giannoni Eric , Stocker Martin , Posfay-Barbe Klara M. , Heininger Ulrich , Bernhard-Stirnemann Sara , Niederer-Loher Anita , Kahlert Christian , Hasters Paul , Relly Christa , Baer Walter , Berger Christoph , Frederick Hannah , Jennings Rebecca , Johnston Joanne , Kenwright Rhian , Pinnock Elli , Agbeko Rachel , Secka Fatou , Bojang Kalifa , Sarr Isatou , Kebbeh Ngange , Sey Gibbi , Momodou  , khan Saidy , Cole Fatoumata , Thomas Gilleh , Antonio Martin , Klobassa Daniela S. , Binder Alexander , Schweintzger Nina A. , Sagmeister Manfred , Baumgart Hinrich , Baumgartner Markus , Behrends Uta , Biebl Ariane , Birnbacher Robert , Blanke Jan-Gerd , Boelke Carsten , Breuling Kai , Brunner Jürgen , Buller Maria , Dahlem Peter , Dietrich Beate , Eber Ernst , Elias Johannes , Emhofer Josef , Etschmaier Rosa , Farr Sebastian , Girtler Ylenia , Grigorow Irina , Heimann Konrad , Ihm Ulrike , Jaros Zdenek , Kalhoff Hermann , Kaulfersch Wilhelm , Kemen Christoph , Klocker Nina , Köster Bernhard , Kohlmaier Benno , Komini Eleni , Kramer Lydia , Neubert Antje , Ortner Daniel , Pescollderungg Lydia , Pfurtscheller Klaus , Reiter Karl , Ristic Goran , Rödl Siegfried , Sellner Andrea , Sonnleitner Astrid , Sperl Matthias , Stelzl Wolfgang , Till Holger , Trobisch Andreas , Vierzig Anne , Vogel Ulrich , Weingarten Christina , Welke Stefanie , Wimmer Andreas , Wintergerst Uwe , Wüller Daniel , Zaunschirm Andrew , Ziuraite Ieva , Žukovskaja Veslava 
Published: November 2019

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.