Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children

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Abstract
The majority of febrile children have self-resolving viral infection, but a small proportion have life-threatening bacterial infections. Although culture of bacteria from normally sterile sites remains the gold standard for confirming bacterial infection, culture results may take several days and are frequently negative when infection resides in inaccessible sites or when antibiotics have been previously administered.1-3 Current practice is to admit ill-appearing febrile children to the hospital and administer parenteral antibiotics while awaiting culture results.4-6 Because only a minority of febrile children are ultimately proven to have bacterial infection, the process of ruling out bacterial infection results in a major burden on health care resources and in inappropriate antibiotic prescription.7