{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:07:52Z","timestamp":1785431272840,"version":"3.56.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"unspecified","delay-in-days":301,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Trans. Sci."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S205986612510191X_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Distinguishing viral versus bacterial lower respiratory tract infection (LRTI) is challenging. We previously developed a rapid, host response-based test (Biomeme HR-B\/V assay) using peripheral blood samples to identify viral versus bacterial infection. We assessed the performance of this assay when using nasopharyngeal (NP) samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205986612510191X_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients with LRTI were enrolled, and a NP swab sample was run using the HR-B\/V assay (assessing 24 gene targets) on the Franklin\n                      <jats:sup>TM<\/jats:sup>\n                      platform. The performance of the prior classifier at identifying viral versus bacterial infection was assessed. A novel predictive model was generated for NP samples using the same 24 targets. Results were validated using external datasets with nasal\/NP RNA sequence data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205986612510191X_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nineteen patients (median age 62 years, 52.1% male) were included. When using the prior HR-B\/V classifier on NP samples of 19 patients with LRTI (12 viral, 7 bacterial), the area under the receiver operator curve (AUC) for viral versus bacterial infection was 0.786 (0.524\u20131), with accuracy 0.79 (95% CI 0.57\u20130.91), positive percent agreement (PPA) 0.43 (95% CI 0.16\u20130.75), and negative percent agreement (NPA) 1.00 (95% CI 0.76\u20131). The novel model had AUC 0.881 (95% CI 0.726\u20131), accuracy 0.84 (95% CI 0.62\u20130.94), PPA 0.86 (95% CI 0.49\u20130.97), and NPA 0.83 (95% CI 0.55\u20130.95) for bacterial infection. Validation in two external datasets showed AUC of 0.932 (95% CI 0.90\u20130.96) and 0.915 (95% CI 0.88\u20130.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205986612510191X_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We show that host response in the nasopharynx can distinguish viral versus bacterial LRTI. These findings need to be replicated in larger cohorts with diverse LRTI etiologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cts.2025.10191","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T05:13:01Z","timestamp":1761714781000},"source":"Crossref","is-referenced-by-count":0,"title":["Host gene expression in the Nasopharynx can discriminate microbiologically confirmed viral and bacterial lower respiratory tract infection"],"prefix":"10.1017","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6012-7271","authenticated-orcid":false,"given":"L. 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