Observational studyEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2018
A host-protein signature is superior to other biomarkers for differentiating between bacterial and viral disease in patients with respiratory infection and fever without source: a prospective observational study.
Observational study in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.
- Diagnostic accuracy of MMBV in predicting bacterial infection in febrile children: a systematic review and meta-analysis.Italian journal of pediatrics · 2026Pooled it
- Effect of host-protein test (TRAIL/IP-10/CRP) on antibiotic prescription and emergency department or urgent care center return visits: The JUNO pilot randomized controlled trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Trial
- Effect of point-of-care C-reactive protein testing on antibiotic prescription in febrile patients attending primary care in Thailand and Myanmar: an open-label, randomised, controlled trial.The Lancet. Global health · 2019Trial
- Performance of a host-protein score (MeMed BV score) for detecting bacterial infections in young children.European journal of pediatrics · 2026Observational
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Diagnostic Performance of the MeMed BV Test to Distinguish Between Bacterial and Viral or Other Non-Bacterial Causes Amongst ED and Urgent Care Patients: A Systematic Review with Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps.Current opinion in pediatrics · 2025Review
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- Validation of a Rapid Host-Protein Score to Discriminate Bacterial from Viral Infections in Hospitalized Febrile Pediatric Patients.Children (Basel, Switzerland) · 2025Article
- Metatranscriptomic profiling reveals pathogen and host response signatures of pediatric acute sinusitis and upper respiratory infection.Genome medicine · 2025Article
- Model-based cost-impact analysis of a diagnostic test for patients with community-acquired pneumonia in Canada.BMC infectious diseases · 2025Article
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- Article
- Diagnostic power of LIAISON MeMed VB® for bacterial infection in adults patients seen in Emergency Departments due to infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Observational
- Application of a Machine Learning-Based Classification Approach for Developing Host Protein Diagnostic Models for Infectious Disease.Diagnostics (Basel, Switzerland) · 2024Article
- A rapid host-protein test for differentiating bacterial from viral infection: Apollo diagnostic accuracy study.Journal of the American College of Emergency Physicians open · 2024Article
- Biomarkers for Serious Bacterial Infections in Febrile Children.Biomolecules · 2024Review
- Impact on Patient Management of a Novel Host Response Test for Distinguishing Bacterial and Viral Infections: Real World Evidence from the Urgent Care Setting.Biomedicines · 2023Article
- The WE SENSE study protocol: A controlled, longitudinal clinical trial on the use of wearable sensors for early detection and tracking of viral respiratory tract infections.Contemporary clinical trials · 2023Article
- Salivary Biomarkers to Differentiate betweenDiagnostics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bacterial and viral infections often present with similar symptoms. Etiologic misdiagnosis can alter the trajectory of patient care, including antibiotic overuse. A host-protein signature comprising tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein (CRP) was validated recently for differentiating bacterial from viral disease. However, a focused head-to-head comparison of its diagnostic performance against other biomarker candidates for this indication was lacking in patients with respiratory infection and fever without source. We compared the signature to other biomarkers and prediction rules using specimens collected prospectively at two secondary medical centers from children and adults. Inclusion criteria included fever > 37.5 °C, symptom duration ≤ 12 days, and presentation with respiratory infection or fever without source. Comparator method was based on expert panel adjudication. Signature and biomarker cutoffs and prediction rules were predefined. Of 493 potentially eligible patients, 314 were assigned unanimous expert panel diagnosis and also had sufficient specimen volume. The resulting cohort comprised 175 (56%) viral and 139 (44%) bacterial infections. Signature sensitivity 93.5% (95% CI 89.1-97.9%), specificity 94.3% (95% CI 90.7-98.0%), or both were significantly higher (all p values < 0.01) than for CRP, procalcitonin, interleukin-6, human neutrophil lipocalin, white blood cell count, absolute neutrophil count, and prediction rules. Signature identified as viral 50/57 viral patients prescribed antibiotics, suggesting potential to reduce antibiotic overuse by 88%. The host-protein signature demonstrated superior diagnostic performance in differentiating viral from bacterial respiratory infections and fever without source. Future utility studies are warranted to validate potential to reduce antibiotic overuse.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.