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Published on: January 30, 2017
Diagnostic Accuracy of a Bacterial Versus Viral Host-protein Test for Children Hospitalized With Acute Infections
Louis Bont1, Adi Klein2,3, Michal Stein4,5
1From the Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, Netherlands.
Background:
A host-protein test's diagnostic accuracy for discriminating bacterial from viral infections [MeMed BV (MMBV)] was established at emergency departments and urgent care settings. We determined its performance in children postadmission and in subcohorts stratified according to timing of the blood draw.
Methods:
We analyzed postadmission MMBV data from children (3 months to 17 years) with suspected acute infections recruited across 5 previous studies. MMBV results were interpreted as bacterial/viral/equivocal according to the manufacturer's instructions. Reference standard infection etiology was as assigned in the original studies, where adjudicators were provided comprehensive patient data but blinded to MMBV. We calculated diagnostic performance by comparing MMBV to the reference standard.
Results:
The study population comprised 1059 children, encompassing 659 patients sampled on admission day (day = 0), 69 patients sampled on day ≥1 of hospital stay and 331 with blood drawn postadmission without recorded timing. Median age was 1.9 years (interquartile range 1.0, 4.0), with 51.5% males. The most prevalent discharge diagnoses were systemic viral infections (29.7%), upper respiratory tract infection (17.6%) and lower respiratory tract infection (14.4%). MMBV attained comparable area under the receiver operating characteristic curves ( P > 0.9) of 0.92 (95% confidence interval: 0.90-0.94) for the study population, 0.92 (0.89-0.94) for those sampled on day = 0, 0.92 (0.82-1.0) for those sampled on day ≥1 of hospital stay and 0.92 (0.88-0.96) for those with sampling time unknown.
Conclusions:
These data support MMBV's performance in hospitalized children. Real-world studies are warranted to establish MMBV's utility postadmission.
Insights
The MeMed BV (MMBV) test accurately distinguishes bacterial from viral infections in hospitalized children. Its diagnostic performance remains high regardless of blood draw timing postadmission.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Diagnostics
- Host-Protein Biomarkers
Background:
- The MeMed BV (MMBV) test, a host-protein assay, has demonstrated diagnostic accuracy for differentiating bacterial from viral infections in emergency and urgent care settings.
- Its performance in pediatric patients after hospital admission and across different blood draw timings required further investigation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the MeMed BV (MMBV) test in hospitalized children.
- To assess MMBV performance in subgroups stratified by the timing of blood collection relative to hospital admission.
Main Methods:
- Analysis of postadmission MMBV data from 1059 children (3 months to 17 years) across five prior studies.
- MMBV results were categorized as bacterial, viral, or equivocal based on manufacturer guidelines.
- Diagnostic performance was determined by comparing MMBV results to reference standard infection etiology, with adjudicators blinded to MMBV results.
Main Results:
- The study included 1059 children, with diagnoses including systemic viral infections, upper respiratory tract infections, and lower respiratory tract infections.
- MMBV achieved a high area under the receiver operating characteristic curve (AUC) of 0.92 across the entire study population and in subgroups based on blood draw timing (day 0, day ≥1, and unknown).
- The AUC remained consistent at 0.92 (95% CI: 0.90-0.94) for the overall cohort and specific subgroups, indicating robust diagnostic capability.
Conclusions:
- The findings support the reliable performance of the MeMed BV (MMBV) test in hospitalized children.
- Further real-world studies are recommended to confirm MMBV's utility in the postadmission clinical setting.
