Diagnostic Performance of the MeMed BV Test to Distinguish Between Bacterial and Viral or Other Non-Bacterial Causes Amongst ED and Urgent Care Patients: A Systematic Review with Meta-Analysis

Background/Objectives: Respiratory tract symptoms, urinary symptoms, and acute fevers frequently prompt emergency urgent care visits. Distinguishing bacterial from viral or non-bacterial etiology remains difficult because clinical features overlap and laboratory microbiological tests are often non-specific or delayed. The MeMed BV® test is a rapid host-response assay that combines TRAIL, IP-10, and CRP into a composite score to differentiate between bacterial and viral/non-bacterial infections within 15 min. The objective of this systematic review and meta-analysis was to evaluate the diagnostic accuracy and clinical utility of the MeMed BV test in adults and children with suspected respiratory tract infections, urinary tract infections, and undifferentiated fever. Methods: The review followed PRISMA-DTA guidelines. Medline, Embase, CINAHL, and the Cochrane Library databases were searched. The risk of bias was assessed using the QUADAS-2, Cochrane RoB 2.0, ROBINS-I, and JBI tools. Where appropriate, meta-analyses were performed using a bivariate random-effects or HSROC model. Results: Sixteen studies (12 diagnostic test accuracy (DTA) studies and four non-DTA studies) were included. The pooled sensitivity was 91% (95% CI: 86–94%), and specificity was 92% (95% CI: 91–93%), with consistent accuracy in adults (Sensitivity 93%/Specificity 91%) and children (Sensitivity 88%/Specificity 93%). The non-DTA studies demonstrated that MeMed BV-guided management improved antibiotic stewardship: antibiotics were prescribed in 20.6% of viral versus 73.2% of bacterial cases, and clinician adherence to MeMed BV results reached 75–80%. Conclusions: The MeMed BV test demonstrates consistently high diagnostic accuracy and is associated with improved antibiotic decision-making, supporting its integration into clinical workflows.