Abstract

Abstract Background The rate of cultures ordered for patients in which infection is suspected is approximately 40% on Emergency Department patients at Maimonides Medical Center and represents a significant financial burden for our institution. Most blood cultures in clinical practice do not grow organisms suggesting that suboptimal blood culture collection practices (e.g., suboptimal blood volume) or suboptimal selection of patients to culture (patients with low likelihood of bacteremia may be occurring. •BV is a new host-protein test based on TRAIL, TNF-related apoptosis inducing ligand protein, IP-10, interferon gamma -induced protein 10 and CRP, C- reactive protein that produces a score between 1–100 indicating the likelihood of a bacterial vs viral infection. It has been validated in multiple studies to have sensitivity and specificity of more than 90%.• In this study we compare blood culture and BV results. Methods BV test were taken at ED physician discretion from March 2022 to December 2022 • BV score 0–35 is viral, 35–65 is equivocal and 65–100 is bacterial. • BV test was measured using MeMed BV (MeMed, Israel) and MeMed Key (MeMed, Israel) from serum samples. • This sub analysis focuses on patients presenting at the ED for whom blood culture was ordered and there was a record of the result. Results • BV test was taken for 545 patients during their ED visit, of these, 389 had blood cultures drawn and results recorded. • There were 233 cases with BV score bacterial, 42 with BV score equivocal and 114 with BV score viral • Out of the BV score viral, there were 7 with positive findings, of which 5 were considered contaminants Conclusion There is a high agreement between viral BV results and negative cultures. Ongoing collection of this data in real time will help establish this finding further in order to provide guidance for our clinicians to reduce the financial burden of unwarranted cultures as well as the unnecessary administration of antibiotics.

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