Evaluation of a Novel Point-of-Care Blood Myxovirus Resistance Protein A Measurement for the Detection of Viral Infection at the Pediatric Emergency Department - UTU Research Portal

A1 Refereed original research article in a scientific journal

Evaluation of a Novel Point-of-Care Blood Myxovirus Resistance Protein A Measurement for the Detection of Viral Infection at the Pediatric Emergency Department

Authors: Piri, Ruut; Ivaska, Lauri; Kujari, Anna-Maija; Julkunen, Ilkka; Peltola, Ville; Waris, Matti

Publisher: Oxford University Press

Publication year: 2024

Journal: Journal of Infectious Diseases

Journal name in source: The Journal of infectious diseases

Journal acronym: J Infect Dis

Volume: 230

Issue: 5

First page : e1049

Last page: e1057

ISSN: 0022-1899

eISSN: 1537-6613

DOI: https://doi.org/10.1093/infdis/jiae367

Web address : https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiae367/7718640

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/457312174

Abstract

Background: Prompt differentiation of viral from bacterial infections in febrile children is pivotal in reducing antibiotic overuse. Myxovirus resistance protein A (MxA) is a promising viral biomarker.

Methods: We evaluated the accuracy of a point-of-care (POC) measurement for blood MxA level compared to the reference enzyme immunoassay in 228 febrile children aged between 4 weeks and 16 years, enrolled primarily at the emergency department (ED). Furthermore, we analyzed the ability of MxA to differentiate viral from bacterial infections.

Results: The mean difference between POC and reference MxA level was -76 µg/L (95% limits of agreement from -409 to 257 µg/L). Using a cutoff of 200 µg/L, POC results were uniform with the reference assay in 199 (87.3%) children. In ED-collected samples, the median POC MxA levels (interquartile range) were 571 [240-955] µg/L in children with viral infections, 555 (103-889) µg/L in children with viral-bacterial co-infections, and 25 (25-54) µg/L in children with bacterial infections (P < 0.001). MxA cutoff of 101 µg/L differentiated between viral and bacterial infections with 92% sensitivity and 91% specificity.

Conclusions: POC MxA measurement demonstrated acceptable analytical accuracy compared to the reference method, and good diagnostic accuracy as a biomarker for viral infections.

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Funding information in the publication:
This work was supported by University of Turku (to R.P.); Research Funds from Specified Government Transfers to Hospital District of Southwest Finland (to R.P. and V.P.); the Foundation for Pediatric Research (to R.P. and V.P.); Maud Kuistila Memorial Foundation (2021-0105B to R.P.); Päivikki and Sakari Sohlberg Foundation (230055 to R.P.); and Labmaster Ltd (to I.J. and M.W). Labmaster Ltd. provided the LUCIA Analyzers and in part the MxA kits for the study. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.