CLN Daily 2024
Identifying and managing acute infections in the emergency department can be challenging for several reasons. The most common issue is that it’s often difficult to tell the difference between bacterial and viral pathogens, especially for patients with upper respiratory problems. Sometimes emergency departments and urgent care centers have no choice but to treat empirically, which can lead to the over-prescription of antibiotics.
One tool that could help: MeMed BV A, a rapid-host response test that can differentiate between bacterial and viral infections.
Alejandro Zuretti, MD, medical director of laboratories at SUNY Downstate, will be hosting a roundtable discussion about this novel technology at ADLM 2024, based on his first-hand experience. SUNY Downstate was part of a pilot program of integrating MeMed BV A into clinical care, and Zuretti will share the experiences from his lab, including how it works, the cost, and how his team implemented it into regular patient workflow.
Technology that can quickly differentiate between viral and bacterial infections could have a major impact on healthcare because of its speed, Zuretti said. His lab found that the tests needed as little as 10 minutes to give a result, meaning that the emergency department could triage the patient quickly. If the pathogen is viral, “you know that you’re not going to need antibiotics and are going to need cultures instead. The approach is completely different than if the pathogen is bacterial.”
Being able to identify the type of pathogen rapidly benefits both the healthcare institution and patients. “Everybody is short on both staff and financial resources. Anything that can help us minimize the resources that are allocated to patient treatment, as well as expedite treatment of a patient can make a difference,” he said. He added that this also means that the interests of the C-suite and the clinical care team are aligned, paving the way to implement a new practice. “Savings on that one patient day of admission could be as much as $2,000,” he said.
Zuretti said this is an important topic for ADLM 2024 because SUNY Downstate’s experience as a large laboratory implementing the test can be helpful to other clinical laboratories. “Not many people are familiar with the details of the test, or how to deploy it.”
Not only is there cost savings, but it can radically improve patient experience, including length of stay, satisfaction with treatment, and, overall morbidity and mortality, especially for children and elderly patients who are most sensitive to upper respiratory infections, Zuretti said. Instead of waiting days or weeks for a culture, clinicians can get preliminary results relatively quickly, which could then get patients the appropriate treatment. “If we can avoid even a percentage of not sending cultures, we’re able to discharge patients much faster,” he said. “If you multiply that for every patient that was admitted for respiratory infections, the potential impact is huge because you are not waiting for cultures and discharging patients on supportive therapy.” This could also mean not giving expensive antibiotics where they won’t help the patient and instead could harm them.
MeMed BV A can also make a clinician’s job easier, Zuretti noted. With this technology, “you’re not treating on the basis of your gut, you’re triaging on the basis of a test.”
Jen A. Miller is a freelance journalist who lives in Audubon, New Jersey. +X: @byJenAMiller.