Rapid detection of bacterial infection using a novel single-tube, four-colour flow cytometric method: Comparison with PCT and CRP

Jari Nuutila,Päivi Jalava-Karvinen,Jarmo Oksi,Ulla Hohenthal

doi:10.1016/j.ebiom.2021.103724

Jari Nuutila, Päivi Jalava-Karvinen + Show 2 more

Open Access

https://doi.org/10.1016/j.ebiom.2021.103724

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Journal: eBioMedicine	Publication Date: Nov 26, 2021
Citations: 3	License type: cc-by

Affiliation: University of Turku, Turku University Hospital

Abstract

BackgroundA key factor behind the unnecessary use of antibiotics is the lack of rapid and accurate diagnostic tests. In this study, we developed a novel and fast flow cytometric single-tube method to detect bacterial infections within 30 minutes.MethodsQuantitative flow cytometric four-colour analysis of host biomarkers CD35, CD64, CD329, and MHC class I expression on neutrophils and lymphocytes was performed on samples taken from 841 febrile patients with suspected infection. Obtained data was incorporated into the four-colour bacterial infection (FCBI)-index, using the developed bacterial infection algorithm.FindingsIn distinguishing between microbiologically confirmed bacterial (n = 193) and viral (n = 291) infections, the FCBI-index method was superior to serum C-reactive protein (CRP) and procalcitonin (PCT). In 269 confirmed viral respiratory tract infections, 43% (95% CI: 37–49%) of the patients had an increased FCBI-index, suggesting probable bacterial coinfection.InterpretationThe proposed FCBI-index test might be a potent additional tool when assessing appropriateness of empiric antibiotic treatment.FundingThis study has been financially supported by Turku University Hospital (Turku, Finland) and The Finnish Medical Foundation.

Highlights

A key factor behind the unnecessary use of antibiotics and the increasing global burden of antimicrobial resistance is the lack of rapid and accurate diagnostic tests [1]
As a result of persistent development work during the last two decades, we have developed a novel and simple flow cytometry-based bacterial infection marker, the four-colour bacterial infection (FCBI)-index, which incorporates the quantitative analysis of CD35, CD64 and CD329 receptors on neutrophils and lymphocytes and detects febrile bacterial infections reliably in less than 30 minutes
We present in this study the truly workable multiparametric flow cytometry method, the Four-Colour Bacterial Infection (FCBI)-index, which is based on detection of the relative number of CD35, CD64 and CD329 receptors on neutrophils and lymphocytes

Summary

Introduction

A key factor behind the unnecessary use of antibiotics and the increasing global burden of antimicrobial resistance is the lack of rapid and accurate diagnostic tests [1]. One candidate is the flow cytometric determination of host markers, receptors, on the surface of blood leukocytes. The increased expression of Fc-gamma-receptor I (FcgRI/CD64) on neutrophils has been the most widely used (and only) commercially available flow cytometric marker of infection (both bacterial and viral), as well as severity of sepsis [3À6]. We developed a novel and fast flow cytometric single-tube method to detect bacterial infections within 30 minutes. Methods: Quantitative flow cytometric four-colour analysis of host biomarkers CD35, CD64, CD329, and MHC class I expression on neutrophils and lymphocytes was performed on samples taken from 841 febrile patients with suspected infection.

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