Discovery and predictive modeling of urine microbiome, metabolite and cytokine biomarkers in hospitalized patients with community acquired pneumonia.

Autor: Pierre JF; Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center (UTHSC), 425 Translational Science Research Building, 71 S Manassas St., Memphis, TN, 28103, USA. Jpierre1@uthsc.edu.; Department of Microbiology, Immunology, and Biochemistry, College of Medicine, UTHSC, 801B Molecular Sciences Building, 858 Madison Ave, Memphis, TN, 38163, USA. Jpierre1@uthsc.edu., Akbilgic O; Department of Health Informatics and Data Sciences, Parkinson School of Health Informatics and Public Health, Loyola University Chicago, Maywood, IL, 60153, USA., Smallwood H; Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center (UTHSC), 425 Translational Science Research Building, 71 S Manassas St., Memphis, TN, 28103, USA., Cao X; Department of Acute and Tertiary Care, College of Nursing, UTHSC, Memphis, USA., Fitzpatrick EA; Department of Microbiology, Immunology, and Biochemistry, College of Medicine, UTHSC, 801B Molecular Sciences Building, 858 Madison Ave, Memphis, TN, 38163, USA., Pena S; Division of Infectious Diseases, School of Medicine, University of Louisville, Louisville, USA., Furmanek SP; Division of Infectious Diseases, School of Medicine, University of Louisville, Louisville, USA., Ramirez JA; Division of Infectious Diseases, School of Medicine, University of Louisville, Louisville, USA., Jonsson CB; Department of Microbiology, Immunology, and Biochemistry, College of Medicine, UTHSC, 801B Molecular Sciences Building, 858 Madison Ave, Memphis, TN, 38163, USA. cjonsson@uthsc.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2020 Aug 07; Vol. 10 (1), pp. 13418. Date of Electronic Publication: 2020 Aug 07.
DOI: 10.1038/s41598-020-70461-9
Abstrakt: Pneumonia is the leading cause of infectious related death costing 12 billion dollars annually in the United States alone. Despite improvements in clinical care, total mortality remains around 4%, with inpatient mortality reaching 5-10%. For unknown reasons, mortality risk remains high even after hospital discharge and there is a need to identify those patients most at risk. Also of importance, clinical symptoms alone do not distinguish viral from bacterial infection which may delay appropriate treatment and may contribute to short-term and long-term mortality. Biomarkers have the potential to provide point of care diagnosis, identify high-risk patients, and increase our understanding of the biology of disease. However, there have been mixed results on the diagnostic performance of many of the analytes tested to date. Urine represents a largely untapped source for biomarker discovery and is highly accessible. To test this hypothesis, we collected urine from hospitalized patients with community-acquired pneumonia (CAP) and performed a comprehensive screen for urinary tract microbiota signatures, metabolite, and cytokine profiles. CAP patients were diagnosed with influenza or bacterial (Streptococcus pneumoniae and Staphylococcus aureus) etiologies and compared with healthy volunteers. Microbiome signatures showed marked shifts in taxonomic levels in patients with bacterial etiology versus influenza and CAP versus normal. Predictive modeling of 291 microbial and metabolite values achieved a + 90% accuracy with LASSO in predicting specific pneumonia etiology. This study demonstrates that urine from patients hospitalized with pneumonia may serve as a reliable and accessible sample to evaluate biomarkers that may diagnose etiology and predict clinical outcomes.
Databáze: MEDLINE
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