%0 Journal Article %T Optimal combination of early biomarkers for infection and sepsis diagnosis in the emergency department: The BIPS study %+ CHU Pitié-Salpêtrière [AP-HP] %+ Cytokines et Inflammation %+ Groupe de recherche clinique Biomarqueurs d’urgence et de réanimation (GRC 14 - BIOSFAST) %+ Hub Bioinformatique et Biostatistique - Bioinformatics and Biostatistics %+ Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)) %+ BIO-RAD %+ Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158) %A Velly, Laetitia %A Volant, Steven %A Fitting, Catherine %A Ghazali, Daniel Aiham %A Salipante, Florian %A Mayaux, Julien %A Monsel, Gentiane %A Cavaillon, Jean-Marc %A Hausfater, Pierre %Z The study was supported by Institut Pasteur and a special grant from BioRad %< avec comité de lecture %@ 0163-4453 %J Journal of Infection %I WB Saunders %V 82 %N 4 %P 11-21 %8 2021-04 %D 2021 %R 10.1016/j.jinf.2021.02.019 %M 33610685 %Z Life Sciences [q-bio]Journal articles %X Objective: To define the best combination of biomarkers for the diagnosis of infection and sepsis in the emergency room.Methods: In this prospective study, consecutive patients with a suspicion of infection in the emergency room were included. Eighteen different biomarkers measured in plasma, and twelve biomarkers measured on monocytes, neutrophils, B and T-lymphocytes were studied and the best combinations determined by a gradient tree boosting approach.Results: Overall, 291 patients were included and analysed, 148 with bacterial infection, and 47 with viral infection. The best biomarker combination which first allowed the diagnosis of bacterial infection, included HLA-DR (human leukocyte antigen DR) on monocytes, MerTk (Myeloid-epithelial-reproductive tyrosine kinase) on neutrophils and plasma metaloproteinase-8 (MMP8) with an area under the curve (AUC) = 0.94 [95% confidence interval (IC95): 0.91;0.97]. Among patients in whom a bacterial infection was excluded, the combination of CD64 expression, and CD24 on neutrophils and CX3CR1 on monocytes ended to an AUC = 0.98 [0.96;1] to define those with a viral infection.Conclusion: In a convenient cohort of patients admitted with a suspicion of infection, two different combinations of plasma and cell surface biomarkers were performant to identify bacterial and viral infection. %G English %L hal-03254428 %U https://u-paris.hal.science/hal-03254428 %~ PASTEUR %~ UNIV-PARIS13 %~ APHP %~ U1158 %~ SORBONNE-UNIVERSITE %~ SORBONNE-UNIV %~ SU-MEDECINE %~ SU-MED %~ SORBONNE-PARIS-NORD %~ UNIV-PARIS %~ UNIVERSITE-PARIS %~ UP-SANTE %~ ALLIANCE-SU