Cabañas Morafraile J, de Rafael González E, Serrano Martín L, Rubio Díaz R, Torres Fernández M, Heredero Gálvez E, López Forero W E, Morell Jurado L, Canabal Berlanga R, Calafell Mas M F, Chaves Prieto E, Asensio Nieto M R, Thomas-Balaguer Cordero A, Lorenzo Lozano M C, Julián-Jiménez A
Dr. Agustín Julián-Jiménez, Servicio de Urgencias-Coordinador de Docencia, Formación, Investigación y Calidad. Complejo Hospitalario Universitario de Toledo, Avda. Río Guadiana s/n. 45071. Toledo, Spain.
Rev Esp Quimioter. 2024 Dec;37(6):486-497. doi: 10.37201/req/078.2024. Epub 2024 Oct 16.
To analyze the diagnostic accuracy of the new MeMed® test to predict bacterial infection in adult patients seen in emergency departments (ED) with clinical suspicion of infection, as well as to compare its performance with other commonly used biomarkers (protein C reactive-PCR-, procalcitonin -PCT-).
A prospective, observational and analytical study was carried out on adult patients who were treated in an ED with the clinical diagnosis of an infectious process. Follow-up was carried out for 30 days. The diagnosis of bacterial infection (BI) was considered as the dependent variable. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (COR) and the values of sensitivity (Se), specificity (Es), positive predictive value (PPV) and negative predictive value (NPV) of the PCR, PCT, leukocyte count and the LIAISON® MeMed® test.
The study included 258 patients, 54 (15.6%) of whom died within 30 days of visiting the ED. The mean age was 68.28 (SD 19.53) years, 57.4% (148) were men. At 30 days, the group with the IB diagnosis had 137 patients, the viral infection group 68 cases and 17 in the indeterminate group. The AUC-COR achieved by MeMed® in the group that analyzes all patients was 0.920 (95% CI: 0.877-0.962) and the PCT was 0.811 (95% CI: 0.754-0.867). With a cut-off point (PC) > 65 points of the MeMed® test, achieves a Se: 79.2% and Es: 91.2% and with PC > 90 points a Se: 57% and Es: 95.9%. Applying the Youden index, the PC > 50 points achieves Se:84.1% and Es:88.2%.
In adult patients treated with clinical suspicion of infection in the ED, the LIAISON MeMed® test has a great ability to diagnose its bacterial origin and achieves better performance than PCT, PCR and leukocyte count.
分析新型MeMed®检测对急诊科（ED）临床怀疑感染的成年患者细菌感染的诊断准确性，并将其性能与其他常用生物标志物（C反应蛋白-PCR、降钙素原-PCT）进行比较。
对在ED接受治疗且临床诊断为感染性疾病的成年患者进行前瞻性、观察性和分析性研究。随访30天。将细菌感染（BI）的诊断视为因变量。使用受试者工作特征曲线（COR）的曲线下面积（AUC）以及PCR、PCT、白细胞计数和LIAISON® MeMed®检测的敏感性（Se）、特异性（Es）、阳性预测值（PPV）和阴性预测值（NPV）分析预测能力。
该研究纳入了258例患者，其中54例（15.6%）在就诊ED后30天内死亡。平均年龄为68.28岁（标准差19.53），57.4%（148例）为男性。30天时，确诊为IB的组有137例患者，病毒感染组68例，不确定组17例。MeMed®在分析所有患者的组中获得的AUC-COR为0.920（95%CI：0.877-0.962），PCT为0.811（95%CI：0.754-0.867）。MeMed®检测的截断点（PC）>65分时，敏感性为79.2%，特异性为91.2%；PC>90分时，敏感性为57%，特异性为95.9%。应用约登指数，PC>50分时，敏感性为84.1%，特异性为88.2%。
在ED临床怀疑感染的成年患者中，LIAISON MeMed®检测对诊断细菌感染具有很强的能力，并且其性能优于PCT、PCR和白细胞计数。
