title: MxA-based recognition of viral illness in febrile children by a whole blood assay.
abstract: Febrile children are often given antibiotics empirically and unnecessarily. MxA is a protein induced in peripheral lymphoid cells by type 1 interferons during active viral infection. The ability of a whole blood ELISA assay for MxA to identify children with viral illness was studied in 122 children who presented with acute onset fever and 52 age-matched healthy controls. The febrile children were divided into three groups according to their final diagnoses: etiologically diagnosed viral infection, clinically diagnosed viral infection, and bacterial infection. MxA levels in the bacterial infection group and controls were similar and low (90.9 +/- 69.7 and 76.9 +/- 63.2 ng/mL, respectively). In contrast, mean MxA levels in the two viral infection groups were higher than in both the bacterial and control groups (719.2 +/- 386.4 and 827.0 +/- 651.1, respectively). A receiver operating characteristic analysis showed that the area under the curve of the MxA level was greater than under the curves of both the white blood cell count and the C-reactive protein concentration. Whole blood assay of MxA is a clinically useful tool for diagnosing viral illness in febrile children and should help reduce use of unnecessary antibiotics.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.
authors.forename: Motokazu
authors.initials: M
authors.lastname: Nakabayashi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Adachi
authors.forename: Toshiko
authors.initials: T
authors.lastname: Itazawa
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Okabe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kanegane
authors.forename: Mizuho
authors.initials: M
authors.lastname: Kawamura
authors.forename: Akihito
authors.initials: A
authors.lastname: Tomita
authors.forename: Toshio
authors.initials: T
authors.lastname: Miyawaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005334:Fever / Q000097:blood* / Q000821:virology*; D019204:GTP-Binding Proteins / Q000097:blood* / Q000235:genetics; D005786:Gene Expression Regulation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D064547:Myxovirus Resistance Proteins; D014777:Virus Diseases / Q000097:blood* / Q000150:complications / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; C579071:MX1 protein, human; D064547:Myxovirus Resistance Proteins; D002097:C-Reactive Protein; D019204:GTP-Binding Proteins