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Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review.

ABSTRACT: Lower respiratory tract infections (LRTIs) are a leading cause of morbidity and mortality in children. The ability of healthcare providers to diagnose and prognose LRTIs in the pediatric population remains a challenge, as children can present with similar clinical features regardless of the underlying pathogen or ultimate severity. Metabolomics, the large-scale analysis of metabolites and metabolic pathways offers new tools and insights that may aid in diagnosing and predicting the outcomes of LRTIs in children. This review highlights the latest literature on the clinical utility of metabolomics in providing care for children with bronchiolitis, pneumonia, COVID-19, and sepsis. IMPACT: This article summarizes current metabolomics approaches to diagnosing and predicting the course of pediatric lower respiratory infections. This article highlights the limitations to current metabolomics research and highlights future directions for the field.

SUBMITTER: Wildman E

PROVIDER: S-EPMC9247944 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review.

Wildman Emily E Mickiewicz Beata B Vogel Hans J HJ Thompson Graham C GC

Pediatric research 20220701 3

Lower respiratory tract infections (LRTIs) are a leading cause of morbidity and mortality in children. The ability of healthcare providers to diagnose and prognose LRTIs in the pediatric population remains a challenge, as children can present with similar clinical features regardless of the underlying pathogen or ultimate severity. Metabolomics, the large-scale analysis of metabolites and metabolic pathways offers new tools and insights that may aid in diagnosing and predicting the outcomes of L ...[more]

PMID: 35778499

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Project description:BackgroundTo evaluate the clinical utility of targeted next-generation sequencing (tNGS) for pathogen detection of pediatric acute lower respiratory tract infections (ALRTIs), with a particular focus on the use of throat swab samples.MethodsIn this diagnostic accuracy study involving 132 children, throat swabs and bronchoalveolar lavage fluid (BALF) samples were collected and analyzed by tNGS, and the results were compared with those obtained from conventional diagnostic methods. The impact of prior antibiotic use on the detection rate of tNGS was evaluated, the consistency between throat swabs and BALF was assessed, and the economic cost and invasiveness of the sampling methods were examined.ResultsThis study enrolled 132 children, of whom 79 (60%) were boys and 53 (40%) were girls. Ninety-two (70%) of the patients had fever, and 128 (97%) had a cough. The detection rates of bacteria, viruses, and atypical pathogens in BALF samples by tNGS were 89.5% (n = 68), 98.2% (n = 108), and 77.8% (n = 63), respectively. Compared to traditional detection methods, tNGS showed significantly higher detection rates for bacteria and viruses (P < 0.001), but there was no statistically significant difference in the detection of atypical pathogens (P = 0.59). The use of antibiotics had no significant effect on bacterial detection by tNGS (P = 0.237). Using BALF-tNGS as the "gold standard," the sensitivities of tNGS of throat swabs for detecting bacteria, viruses, and atypical pathogens were 95.83%, 88.16%, and 92.06%, respectively, with specificities of 55.95%, 83.93%, and 100%. In the analysis of economic costs and invasiveness, the cost of throat swab sampling was significantly lower than that of BALF sampling, and the associated pain score and complication rate were significantly lower (P < 0.05).ConclusionstNGS with throat swabs offers higher sensitivity and specificity than traditional methods for diagnosing pediatric ALRTIs. As such, it offers a less invasive, more cost-effective alternative to BALF sampling.

Project description:IntroductionThe burden of lower respiratory tract infections (LRTIs) is a substantial public health concern. However, the epidemiology of LRTI and its bacterial aetiologies are poorly characterised, particularly in the African continent. Providing accurate data can help design cost-effective interventions to curb the burden of respiratory infections in Africa. Therefore, the aim of this systematic review and meta-analysis will be to determine the prevalence of respiratory Bacterial Aetiologies in people with low Respiratory tract Infections in Africa (BARIAFRICA) and associated factors.Methods and analysisWe will search PubMed, EMBASE, Web of Science, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, and Global Index Medicus to identify studies that reported the prevalence (of enough data to compute this estimate) of respiratory bacterial infections in people with LRTIs in Africa from 1 January 2000 to 31 March 2018, without any linguistic restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently by two investigators. Heterogeneity will be evaluated using the χ² test on Cochran's Q statistic and quantified with H and I² statistics. Prevalence will be pooled using a random-effect meta-analysis model. Subgroup and meta-regression analyses will be used to identify sources of heterogeneity of prevalence estimates. This study will be reported according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationSince this study will be based on published data, it does not require ethical approval. This systematic review and meta-analysis is intended to serve as a basis for determining the burden of LRTIs, for identifying data gaps and for guiding future investigations in Africa. The final report will be published in peer-reviewed journals, presented in conferences and submitted to relevant health policy makers.Prospero registration numberCRD42018092359.

Dataset Information

Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review.

Publications

Metabolomics in pediatric lower respiratory tract infections and sepsis: a literature review.

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