Personalized Risk Assessment in Febrile Illness to Optimize Real-Life Management (Host Rna Signature in Discriminating Adenoviral Vs Bacterial Infection)

Febrile illness is one of the most common pediatric emergent diseases seeking for medical help in Taiwan. Infectious disease, especially viral or bacterial infection are the most common causes. Up to date, there is no single perfect diagnostic tool available for rapid and accurate differentiation between viral and bacterial infection. Although there are some microbiological detection kits on the market providing as adjuvant diagnostic tool in clinical practice, there are limitations for widespread implication because of the sensitivity and specificity of product itself. Another concern is that asymptomatic bacterial colonization over nasopharynx is common in children. The positive detection of microbes from nonsterile site specimen only indicates presence of microbes, could not differentiate between colonization and infection. Therefore, developing omnidirectional modalities is crucial for accurate and specific diagnosis of childhood febrile illness. This project is through joining the European consortium, directed by Imperial College, London, UK and to target on biomarker discovery in febrile children. The ultimate goal of EU consortium is to explore the proteomic and RNA transcriptome in childhood febrile illness in according to the specific causative diseases. In my previous study, I already found that human adenovirus infection could mimic bacterial infection in many clinical settings and also have leukocytosis and high C-reactive protein, as bacterial infection do. Therefore, in current study, we will focus on identifying the specific biomarkers in distinguishing adenovirus from bacterial infection. Through collaboration with the EU consortium, I will recruit clinical cases from Taiwan to join the international study and share the research resource together. In this way, I will have access to the database of the clinical cohort for further bioinformatic analysis. With the implication of bioinformatics analysis result, we aim to provide more individual-based diagnostic evaluation, to decrease unnecessary antimicrobial use, and to the goal of precision medicine.