Abstract Background The DiaSorin LIAISON® MeMed BV® is a semi-quantitative assay that uses chemiluminescent immunoassay (CLIA) technology to measure three non-microbial (host) proteins (TRAIL, IP-10, and CRP) in adult and pediatric serum samples. When used in conjunction with clinical assessments and other laboratory findings, this test has been shown to aid in the differentiation between acute bacterial and viral lower respiratory tract infections in patients presenting to the emergency department or urgent care center with symptoms for seven days or less. The potential utility of this assay in more complicated clinical cases or patient populations, such as those who present with additional co-morbidities along with acute respiratory infections or who present with sepsis, has been less well-studied. Therefore, the purpose of this pilot study was to assess the potential clinical impact of the LIAISON® MeMed BV® test (performed on the LIAISON® analyzer) when used as part of the diagnostic work-up for adult patients with suspected acute respiratory infections, sepsis, and/or fever without source presenting to the emergency department at an urban academic medical center. Methods Participants were recruited from a pool of adults = 18 years presenting to our urban academic medical center emergency department with suspected acute lower respiratory tract infection (with or without fever) and/or sepsis of an unidentified source. Informed consent was obtained prior to study enrollment, after which a study blood sample was collected aseptically by venipuncture, allowed to clot, and the serum separated from the clot as soon as possible. Freshly collected samples were processed (clotting, centrifugation and serum separation) within two hours. Processed samples were considered stable for 8 hours at 2-8°C, or for 3 hours at room temperature; samples were stored frozen (-20°C or below) for up to 12 weeks in glass or plastic vials. Following processing, samples were tested using the LIAISON® MeMed BV® test performed on the LIAISON® analyzer, which generates a numeric score that falls within discrete interpretation ranges based on the increasing likelihood of bacterial infection. Results A total of 38 participants were enrolled in the study and able to provide blood specimens for testing. Participant ages ranged from 18 to 82 years old. LIAISON® MeMed BV® testing of collected samples from this participant pool resulted in 37 total results, with an analyte failure for one of the 38 specimens. Of the 37 results, approximately 73% (n = 24) indicated a likelihood of a bacterial infection at the time of collection, while 19% (n = 7) indicated a viral or non-infectious etiology. Comparatively, six of the tested samples (16%) had equivocal results. Conclusion The results of this pilot study indicate a high prevalence of likely bacterial infections within the cohort of participants tested in our emergency department setting at our urban academic medical center. Further electronic health record review will determine whether the MeMed BV® test and corresponding interpretation may support clinical decision making for the heterogenous patient population in this clinical setting.
Adeyemi et al. (Wed,) studied this question.