A generalizable 29-mRNA neural-network classifier for acute bacterial and viral infections

Nat Commun. 2020 Mar 4;11(1):1177. doi: 10.1038/s41467-020-14975-w.

Abstract

Improved identification of bacterial and viral infections would reduce morbidity from sepsis, reduce antibiotic overuse, and lower healthcare costs. Here, we develop a generalizable host-gene-expression-based classifier for acute bacterial and viral infections. We use training data (N = 1069) from 18 retrospective transcriptomic studies. Using only 29 preselected host mRNAs, we train a neural-network classifier with a bacterial-vs-other area under the receiver-operating characteristic curve (AUROC) 0.92 (95% CI 0.90-0.93) and a viral-vs-other AUROC 0.92 (95% CI 0.90-0.93). We then apply this classifier, inflammatix-bacterial-viral-noninfected-version 1 (IMX-BVN-1), without retraining, to an independent cohort (N = 163). In this cohort, IMX-BVN-1 AUROCs are: bacterial-vs.-other 0.86 (95% CI 0.77-0.93), and viral-vs.-other 0.85 (95% CI 0.76-0.93). In patients enrolled within 36 h of hospital admission (N = 70), IMX-BVN-1 AUROCs are: bacterial-vs.-other 0.92 (95% CI 0.83-0.99), and viral-vs.-other 0.91 (95% CI 0.82-0.98). With further study, IMX-BVN-1 could provide a tool for assessing patients with suspected infection and sepsis at hospital admission.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease / mortality
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / diagnosis*
  • Bacterial Infections / microbiology
  • Bacterial Infections / mortality
  • Datasets as Topic
  • Female
  • Gene Expression Profiling / methods*
  • Hospital Mortality
  • Host-Pathogen Interactions / genetics
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Neural Networks, Computer*
  • RNA, Messenger / metabolism
  • ROC Curve
  • Sepsis / diagnosis*
  • Sepsis / microbiology
  • Sepsis / mortality
  • Support Vector Machine
  • Virus Diseases / diagnosis*
  • Virus Diseases / mortality
  • Virus Diseases / virology

Substances

  • RNA, Messenger