BACKGROUND: The SepsiChip project explored transcriptional modulation associated with ventilator-associated pneumonia (VAP) in patients admitted to the intensive care unit for trauma. Genome-wide expression analysis may help to identify potential diagnostic markers for diseases. The current study examined the changes in blood transcriptome during VAP. METHODS: The authors prospectively included 165 trauma patients, and 41 developed VAP. Whole blood samples were collected at admission and at VAP. To predict VAP, the admission samples were compared by microarray in patients who did or did not develop VAP. To identify diagnosis markers, paired samples of 35 patients who developed VAP were analyzed. Using NanoString (Seattle, WA), the results were confirmed in the patients who developed VAP. Trauma patients who did not develop VAP served as controls to eliminate a time effect. RESULTS: The injury severity scores of the patients who did or did not develop VAP were 36 and 29, respectively. No predictive biomarker was identified. For patients who developed VAP, a transcriptional signature was identified between the two sampling times. However, this signature was a generalized pattern related to trauma, independent of the infectious process. Genes involved in the proinflammatory response were down-regulated in the patients who developed VAP, but this difference was not statistically significant. CONCLUSIONS: In contrast to clinical assessment, transcriptional analysis of whole blood samples cannot predict or diagnose VAP in trauma patients. Differentiating infection from inflammation seems challenging.
BACKGROUND: The SepsiChip project explored transcriptional modulation associated with ventilator-associated pneumonia (VAP) in patients admitted to the intensive care unit for trauma. Genome-wide expression analysis may help to identify potential diagnostic markers for diseases. The current study examined the changes in blood transcriptome during VAP. METHODS: The authors prospectively included 165 traumapatients, and 41 developed VAP. Whole blood samples were collected at admission and at VAP. To predict VAP, the admission samples were compared by microarray in patients who did or did not develop VAP. To identify diagnosis markers, paired samples of 35 patients who developed VAP were analyzed. Using NanoString (Seattle, WA), the results were confirmed in the patients who developed VAP. Traumapatients who did not develop VAP served as controls to eliminate a time effect. RESULTS: The injury severity scores of the patients who did or did not develop VAP were 36 and 29, respectively. No predictive biomarker was identified. For patients who developed VAP, a transcriptional signature was identified between the two sampling times. However, this signature was a generalized pattern related to trauma, independent of the infectious process. Genes involved in the proinflammatory response were down-regulated in the patients who developed VAP, but this difference was not statistically significant. CONCLUSIONS: In contrast to clinical assessment, transcriptional analysis of whole blood samples cannot predict or diagnose VAP in traumapatients. Differentiating infection from inflammation seems challenging.
Authors: Basem Al-Omari; Peter McMeekin; A Joy Allen; Ahsan R Akram; Sara Graziadio; Jana Suklan; William S Jones; B Clare Lendrem; Amanda Winter; Milo Cullinan; Joanne Gray; Kevin Dhaliwal; Timothy S Walsh; Thomas H Craven Journal: BMC Pulm Med Date: 2021-06-09 Impact factor: 3.317
Authors: Thomas P Hellyer; Andrew Conway Morris; Daniel F McAuley; Timothy S Walsh; Niall H Anderson; Suveer Singh; Paul Dark; Alistair I Roy; Simon V Baudouin; Stephen E Wright; Gavin D Perkins; Kallirroi Kefala; Melinda Jeffels; Ronan McMullan; Cecilia M O'Kane; Craig Spencer; Shondipon Laha; Nicole Robin; Savita Gossain; Kate Gould; Marie-Hélène Ruchaud-Sparagano; Jonathan Scott; Emma M Browne; James G MacFarlane; Sarah Wiscombe; John D Widdrington; Ian Dimmick; Ian F Laurenson; Frans Nauwelaers; A John Simpson Journal: Thorax Date: 2014-10-08 Impact factor: 9.102
Authors: Joseph M Swanson; G Christopher Wood; Lijing Xu; Lisa E Tang; Bernd Meibohm; Ramin Homayouni; Martin A Croce; Timothy C Fabian Journal: PLoS One Date: 2012-08-15 Impact factor: 3.240