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急诊科疑似呼吸道感染患者中FebriDx快速即时检测在鉴别细菌和病毒呼吸道感染中的性能

Performance of the FebriDx Rapid Point-of-Care Test for Differentiating Bacterial and Viral Respiratory Tract Infections in Patients with a Suspected Respiratory Tract Infection in the Emergency Department.

作者信息

Tong-Minh Kirby, Daenen Katrijn, Endeman Henrik, Ramakers Christian, Gommers Diederik, van Gorp Eric, van der Does Yuri

机构信息

Department of Emergency Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.

Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.

出版信息

J Clin Med. 2023 Dec 27;13(1):163. doi: 10.3390/jcm13010163.

Abstract

FebriDx is a rapid point-of-care test combining qualitative measurements of C-reactive protein (CRP) and Myxovirus Resistance Protein A (MxA) using a disposable test device to detect and differentiate acute bacterial from viral respiratory tract infections. The goal of this study was to investigate the diagnostic accuracy of FebriDx in patients with suspected respiratory tract infections in the emergency department (ED). This was an observational cohort study, performed in the ED of an academic hospital. Patients were included if they had a suspected infection. The primary outcome was the presence of a bacterial or viral infection, determined by clinical adjudication by an expert panel. The sensitivity, specificity, and positive and negative predictive value of FebriDx for the presence of bacterial versus non-bacterial infections, and viral versus non-viral infections were calculated. Between March 2019 and November 2020, 244 patients were included. A bacterial infection was present in 41%, viral infection was present in 24%, and 4% of the patients had both viral and bacterial pathogens. FebriDx demonstrated high sensitivity in the detection of bacterial infection (87%), high NPV (91%) to rule out bacterial infection, and high specificity (94%) for viral infection in patients with a suspected infection in the ED.

摘要

FebriDx是一种即时快速检测,它使用一次性检测设备对C反应蛋白(CRP)和抗黏液病毒蛋白A(MxA)进行定性测量,以检测和区分急性细菌性与病毒性呼吸道感染。本研究的目的是调查FebriDx在急诊科(ED)疑似呼吸道感染患者中的诊断准确性。这是一项在一家学术医院急诊科进行的观察性队列研究。如果患者疑似感染则纳入研究。主要结局是由专家小组进行临床判定确定的细菌或病毒感染情况。计算了FebriDx对于细菌性与非细菌性感染、病毒性与非病毒性感染存在情况的敏感性、特异性以及阳性和阴性预测值。在2019年3月至2020年11月期间,共纳入244例患者。41%的患者存在细菌感染,24%的患者存在病毒感染,4%的患者同时存在病毒和细菌病原体。FebriDx在检测细菌性感染方面表现出高敏感性(87%),在排除细菌性感染方面具有高阴性预测值(91%),并且在急诊科疑似感染患者中对病毒感染具有高特异性(94%)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c877/10779507/8e7fe34e78c7/jcm-13-00163-g001.jpg

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