61 The distribution of MeMed BV assay results in Children hospitalized at McMaster Children’s Hospital with Severe community-acquired pneumonia (DISCOTHEQUE)

Abstract Background Community-acquired pneumonia (CAP) is a leading cause of paediatric hospitalization. Most CAP in preschoolers is viral, but almost all children hospitalized with CAP are treated with antibiotics – this is a key stewardship gap. Commonly-used biomarkers do not reliably distinguish bacterial from viral pneumonia. However, a novel combination biomarker assay (MeMed BV, MBV) appears to have better discriminatory ability. Objectives To describe the MBV distribution in children hospitalized with CAP at a children’s hospital. Design/Methods A prospective cohort study at a tertiary center enrolling children aged 3+ months hospitalized with CAP. Data abstracted included demographics, presenting signs and symptoms, and clinical outcomes. Participants had MBV testing but results were not available to treating clinicians. Results 98 patients were enrolled, of whom 67 had results available. The mean age of participants was 6.24 years (SD=4.66) and all were treated with antibiotics. A significant proportion (40%) of participants had MBV results suggestive of viral infection (table 1). There was no association between having a positive nasopharyngeal swab and MBV result (p=0.68). 24 of 27 patients who were identified as at least moderate likelihood of viral infection had consolidation or pneumonia reported on their chest x-ray. Conclusion Use of the MBV assay may permit better identification of children hospitalized with severe CAP who are likely to have primary viral disease, for whom antibiotics may offer more potential harm than benefit. Our results will be critical to plan future intervention studies leveraging the MBV assay to better design management algorithms to optimize stewardship.