Evaluation of a combined @entity13434 and CRP point-of-care immunoassay to identify viral and/or bacterial immune response in XXXX with @entity1729 .

@entity1 @entity7551 @entity2348 @entity1800 @entity1729 @entity13434 @entity1851
BACKGROUND: Challenges in the clinical differentiation of @entity1729 lead to the misappropriation of antibiotics and increased healthcare costs. A tool to facilitate rapid and accurate point-of-care (POC) differentiation is needed. METHODS AND FINDINGS: A prospective, single center, blinded, observational clinical trial was conducted at Beth Israel Deaconess Medical Center from December 2012 to August 2013 to determine the accuracy of a POC immunoassay to identify a clinically significant immune response to viral and/or @entity2348 . Sixty @entity1 with @entity1729 (19 @entity7551 and 41 lower respiratory tract infection [LRTI]) were enrolled. @entity1 provided fingerstick blood for immunoassay testing (myxovirus A [ @entity13434 ] and @entity1851 [CRP]) and four oropharyngeal samples for viral PCR and routine bacterial cell culture. A venous blood sample was collected. An ELISA was used to measure CRP and @entity13434 . Paired serological testing was used to confirm atypical bacteria. A urine sample was provided for Streptococcus and Legionella antigen testing. @entity1 with suspected LRTI had sputum and blood cultures, chest X-ray, and WBC count measured. @entity1800 was confirmed if oropharyngeal PCR was positive for viral pathogens. @entity2348 was confirmed in positive throat or sputum cultures. Elevated immunoglobulin M antibodies or twofold increase in IgG antibodies between acute and convalescent phase indicated atypical bacteria. Positive Streptococcus or Legionella urine antigen assays also confirmed @entity2348 . The immunoassay correctly categorized subjects as 92% (22/24) negative, 80% (16/20) with @entity2348 , and 70% (7/10) with @entity1800 . CONCLUSIONS: The interplay between an @entity13434 value and a semi-quantitative CRP value can aid in the differentiation of infectious etiology. In isolation, neither @entity13434 nor CRP alone is sensitive or specific. However, the pattern of results in a rapid immunoassay provides a sensitive and specific method to differentiate @entity1729 . This diagnostic information may help reduce antibiotic misuse and resistance and lower healthcare costs.
