Host gene expression classifiers diagnose acute respiratory illness etiology

Antibiotic resistance is becoming an increasingly hot topic in the news.  The drugs we have been using in the last few decades are starting to face some serious problems with the development of various antibiotic-resistant super bugs.  A great deal of research has been conducted lately regarding ways we can curb this trend to ensure the medications we have will be able to work long into the future.

One cause of growing antibiotic resistant is the mis-diagnosis and subsequent mis-treatment of common respiratory infections.  Often when a patient visits the doctor with this kind of illness, the doctor will prescribe antibiotics without determining if the infection is actually bacterial based or viral based.  A recent article looked at a possible test that could distinguish between the two types of infections, therefore leading to more accurate treatment and curbing inappropriate use of antibiotics.

The researchers analyzed host RNA looking for identifiers that would indicate whether the host, or patient, was responding to a bacterial or viral infection.  It analyzed data on what genes are expressed or over-expressed during each kind of infection to set classifications by which they would be able to analyze the subject’s genetics.

Using these new classifications the prediction of infection type overall in subjects was 87% accurate.

I feel like this could be an extremely impactful test if it becomes implemented in the community setting.  I know so many friends who simply expect antibiotics from their physician when they have a cough.  This puts pressure on the physician to prescribe even if they are not sure of the diagnosis.  With this test it would aid physicians in making a firm diagnosis that they could explain to the patients, curbing inappropriate antibiotic use for viral respiratory infections.

Overall, it seems like this would be a worthwhile test to implement. What problems could arise with the implementation of such a test in a physician’s office?

Tsalik EL, Henao R, Nichols M, et al. Host gene expression classifiers diagnose acute respiratory illness etiology. Sci Transl Med. 2016;8:1-11.

http://stm.sciencemag.org/content/8/322/322ra11