Differentiating between a bacterial and viral infection is vital for both patient health and antimicrobial stewardship—but for many infections, the similarity in patient symptoms makes it challenging. Studies investigating the use of single biomarkers, for example, procalcitonin (PCT) or C-reactive protein (CRP), have shown poor predictive as individual biomarkers. Integration of diagnostic tests based on the host’s response to infection may overcome the challenges and variability presented by using individual biomarkers.

MeMed BV is a diagnostic assay that uses a proprietary algorithm to create a numerical bacterial vs. viral likelihood score based on levels of three host immune proteins—TRAIL (Tumor Necrosis Factor (TNF)-related apoptosis-inducing ligand), IP-10 (interferon gamma-induced protein-10), and CRP. A previous study showed that MeMed BV demonstrated sensitivities of >93% and 98% with specificities of >94% and 88% in children¹ and adults,² respectively.

In this prospective multi-center, blinded study,³ scientists evaluated the diagnostic accuracy of a rapid version of the MeMed BV platform in children and adults in both Emergency Departments and Urgent Care Centers and to determine whether MeMed BV results could impact antibiotic use for these patients. MeMed BV performance was assessed for differentiating between bacterial and viral infections by comparing the results to the reference standard infection etiology. Bacterial (or co-infection) was considered positive.

The study found:

• MeMed BV significantly outperformed PCT in differentiating between bacterial and viral infections with an AUC of 0.95 as compared with 0.70, respectively
• Using MeMed BV could potentially have reduced antibiotic prescription in patients with a viral reference standard infection etiology by 2.2-fold, from19.9% to 8.9%. Of the total cohort, 74 received antibiotics, but MeMed indicated that 60 of them had viral infections
• MeMed BV showed 90.0% sensitivity and 92.8% specificity with a negative predictive value of 98.8% for identification of bacterial vs. viral infections

Adding MeMed BV to the evaluation of acute care patients could help reduce diagnostic uncertainty, which, in turn, could improve antibiotic stewardship and patient outcomes.

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Reference:

1. Papan C, Argentiero A, Porwoll M, et al. A host signature based on TRAIL, IP-10, and CRP for reducing antibiotic overuse in children by differentiating bacterial from viral infections: a prospective, multicentre cohort study. Clin Microbiol Infect. 2022;28(5):723-730. doi:10.1016/j.cmi.2021.10.019

2. Halabi S, Shiber S, Paz M, et al. Host test based on tumor necrosis factor-related apoptosis-inducing ligand, interferon gamma-induced protein-10 and C-reactive protein for differentiating bacterial and viral respiratory tract infections in adults: diagnostic accuracy study. Clin Microbiol Infect. 2023;29(9):1159-1165. doi:10.1016/j.cmi.2023.05.033

3. Bachur RG, Kaplan SL, Arias CA, et al. A rapid host-protein test for differentiating bacterial from viral infection: Apollo diagnostic accuracy study. Journal of the American College of Emergency Physicians Open. 2024;5(3):e13167. doi:10.1002/emp2.13167