Systematic comparison of published host gene expression signatures for bacterial/viral discrimination.

dc.contributor.author

Bodkin, Nicholas

dc.contributor.author

Ross, Melissa

dc.contributor.author

McClain, Micah T

dc.contributor.author

Ko, Emily R

dc.contributor.author

Woods, Christopher W

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Ginsburg, Geoffrey S

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Henao, Ricardo

dc.contributor.author

Tsalik, Ephraim L

dc.date.accessioned

2022-04-01T13:24:49Z

dc.date.available

2022-04-01T13:24:49Z

dc.date.issued

2022-02-21

dc.date.updated

2022-04-01T13:24:49Z

dc.description.abstract

Background

Measuring host gene expression is a promising diagnostic strategy to discriminate bacterial and viral infections. Multiple signatures of varying size, complexity, and target populations have been described. However, there is little information to indicate how the performance of various published signatures compare to one another.

Methods

This systematic comparison of host gene expression signatures evaluated the performance of 28 signatures, validating them in 4589 subjects from 51 publicly available datasets. Thirteen COVID-specific datasets with 1416 subjects were included in a separate analysis. Individual signature performance was evaluated using the area under the receiving operating characteristic curve (AUC) value. Overall signature performance was evaluated using median AUCs and accuracies.

Results

Signature performance varied widely, with median AUCs ranging from 0.55 to 0.96 for bacterial classification and 0.69-0.97 for viral classification. Signature size varied (1-398 genes), with smaller signatures generally performing more poorly (P < 0.04). Viral infection was easier to diagnose than bacterial infection (84% vs. 79% overall accuracy, respectively; P < .001). Host gene expression classifiers performed more poorly in some pediatric populations (3 months-1 year and 2-11 years) compared to the adult population for both bacterial infection (73% and 70% vs. 82%, respectively; P < .001) and viral infection (80% and 79% vs. 88%, respectively; P < .001). We did not observe classification differences based on illness severity as defined by ICU admission for bacterial or viral infections. The median AUC across all signatures for COVID-19 classification was 0.80 compared to 0.83 for viral classification in the same datasets.

Conclusions

In this systematic comparison of 28 host gene expression signatures, we observed differences based on a signature's size and characteristics of the validation population, including age and infection type. However, populations used for signature discovery did not impact performance, underscoring the redundancy among many of these signatures. Furthermore, differential performance in specific populations may only be observable through this type of large-scale validation.
dc.identifier

10.1186/s13073-022-01025-x

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1756-994X

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1756-994X

dc.identifier.uri

https://hdl.handle.net/10161/24746

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

Genome medicine

dc.relation.isversionof

10.1186/s13073-022-01025-x

dc.subject

Humans

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Bacterial Infections

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Virus Diseases

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Diagnosis, Differential

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Cohort Studies

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Gene Expression Profiling

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Publications

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Adult

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Child

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Host-Pathogen Interactions

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Validation Studies as Topic

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Genetic Association Studies

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Transcriptome

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Datasets as Topic

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Biomarkers

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COVID-19

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SARS-CoV-2

dc.title

Systematic comparison of published host gene expression signatures for bacterial/viral discrimination.

dc.type

Journal article

duke.contributor.orcid

Woods, Christopher W|0000-0001-7240-2453

duke.contributor.orcid

Ginsburg, Geoffrey S|0000-0003-4739-9808

duke.contributor.orcid

Tsalik, Ephraim L|0000-0002-6417-2042

pubs.begin-page

18

pubs.issue

1

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Molecular Genetics and Microbiology

pubs.publication-status

Published

pubs.volume

14

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