ArticlePloS one2023
Bacterial vs viral etiology of fever: A prospective study of a host score for supporting etiologic accuracy of emergency department physicians.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- 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
- Sepsis as a complex syndrome: Are combined biomarkers the future of diagnosis and prognosis? Clinical perspective.Immunology letters · 2026Review
- Clinical utility of a host-protein test for suspected infection in the pediatric emergency department: a pragmatic pre-/post-implementation study.Frontiers in pediatrics · 2026Article
- A new biomarker combination differentiates viral from bacterial infections and helps monitoring response to antibiotics in hospitalized children.Scientific reports · 2025Observational
- A Host-Protein Test for Differentiating Bacterial From Viral Infection: Diagnostic Accuracy in Elderly Patients.Journal of the American College of Emergency Physicians open · 2025Article
- Real-World Utility of the Host-Response MeMed BV Test in a Pediatric Emergency Department: A Non-Randomized Study with Optimized Antimicrobial and Diagnostic Stewardship.Children (Basel, Switzerland) · 2025Article
- Article
- Hemoperfusion with Seraph-100 in septic patients removes pathogens and improves clinical outcomes.Scientific reports · 2025Article
- Article
- Proteomic, metabolomic and lipidomic profiles in community acquired pneumonia for differentiating viral and bacterial infections.Scientific reports · 2025Article
- Review: Diagnostic Potential for Collaborative Pharyngitis Biomarkers.The Journal of infectious diseases · 2024Review
- Host-response transcriptional biomarkers accurately discriminate bacterial and viral infections of global relevance.Scientific reports · 2023Article
- 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
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA host-protein score (BV score) that combines the circulating levels of TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10) and C-reactive protein (CRP) was developed for distinguishing bacterial from viral infection. This study assessed the potential of the BV score to impact decision making and antibiotic stewardship at the emergency department (ED), by comparing BV score's performance to physician's etiological suspicion at patient presentation.
methodsRosetta study participants, aged 3 months to 18 years with febrile respiratory tract infection or fever without source, were prospectively recruited in a tertiary care pediatric ED. 465 patients were recruited, 298 met eligibility criteria and 287 were enrolled. ED physician's etiological suspicion was recorded in a questionnaire. BV score was measured retrospectively with results interpreted as viral, bacterial or equivocal and compared to reference standard etiology, which was adjudicated by three independent experts based on all available data. Experts were blinded to BV scores.
resultsMedian age was 1.3 years (interquartile range 1.7), 39.7% females. 196 cases were reference standard viral and 18 cases were reference standard bacterial. BV score attained sensitivity of 88.9% (95% confidence interval: 74.4-100), specificity 92.1% (88.1-96.0), positive predictive value 53.3% (35.5-71.2) and negative predictive value 98.8% (97.1-100). Positive likelihood ratio was 11.18 (6.59-18.97) and negative likelihood ratio was 0.12 (0.03-0.45). The rate of BV equivocal scores was 9.4%. Comparing physician's suspicion to BV score and to the reference standard, and assuming full adoption, BV score could potentially correct the physician's diagnosis and reduce error ~2-fold, from 15.9% to 8.2%.
conclusionsBV score has potential to aid the diagnostic process. Future studies are warranted to assess the impact of real-time BV results on ED practice.
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