About: Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia

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About: Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia
Creator	Alviset, Sophie Auger, Gabriel Duquaire, Paul Gastli, Nabil Monard, Céline Pehlivan, Jonathan Dinh, Alexy
Source	PMC
abstract	BACKGROUND: Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP). METHODS: This retrospective multicenter study was conducted in four French university hospitals. Respiratory samples were obtained from patients with clinical and radiological signs of pneumonia and simultaneously tested using conventional microbiological methods and the rm-PCR. A committee composed of an intensivist, a microbiologist, and an infectious diseases specialist retrospectively assessed all medical files and agreed on the most appropriate antimicrobial therapy for each pneumonia episode, according to the results of rm-PCR and blinded to the culture results. The rm-PCR-guided antimicrobial regimen was compared to the empirical treatment routinely administered to the patient in standard care. RESULTS: We included 159 pneumonia episodes. Most patients were hospitalized in intensive care units (n = 129, 81%), and episodes were HAP (n = 68, 43%), CAP (n = 54, 34%), and VAP (n = 37, 23%). Conventional culture isolated ≥ 1 microorganism(s) at significant level in 95 (60%) patients. The syndromic rm-PCR detected at least one bacteria in 132 (83%) episodes. Based on the results of the rm-PCR, the multidisciplinary committee proposed a modification of the empirical therapy in 123 (77%) pneumonia episodes. The modification was a de-escalation in 63 (40%), an escalation in 35 (22%), and undetermined in 25 (16%) patients. In microbiologically documented episodes (n = 95), the rm-PCR increased appropriateness of the empirical therapy to 83 (87%), as compared to 73 (77%) in routine care. CONCLUSIONS: Use of a syndromic rm-PCR test has the potential to reduce unnecessary antimicrobial exposure and increase the appropriateness of empirical antibiotic therapy in adult patients with pneumonia.
has issue date	2020-07-14(xsd:dateTime)
bibo:doi	10.1186/s13054-020-03114-y
has license	cc-by
sha1sum (hex)	6e738438e5e798eef16a79158dd46e2b24c5c68b
schema:url	https://doi.org/10.1186/s13054-020-03114-y
resource representing a document's title	Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia
has PubMed Central identifier	PMC7359443
schema:publication	Crit Care
resource representing a document's body	covid:6e738438e5e798eef16a79158dd46e2b24c5c68b#body_text
is schema:about of	named entity 'hospital-acquired pneumonia' named entity 'specialist' named entity 'CAP' named entity 'retrospectively' named entity 'culture' named entity 'microbiologist' named entity 'pneumonia' named entity 'INFECTIOUS DISEASES' named entity 'SYNDROMIC' named entity 'ASSESSED' named entity 'STANDARD' named entity 'CULTURE' named entity 'HOSPITAL' named entity 'HAP' named entity 'microbiological' named entity 'antimicrobial' named entity 'committee' named entity 'Respiratory' named entity 'patients' named entity 'medical files' named entity 'pneumonia' named entity 'pathogen' named entity 'PCR' named entity 'PCR' named entity 'antimicrobial' named entity 'pneumonia' named entity 'empirical treatment' named entity 'compared' named entity 'AST' named entity 'de-escalation' named entity 'pathogens' named entity 'prednisone' named entity 'empirical therapy' named entity 'mecA' named entity 'antibiotics' named entity 'resistance genes' named entity 'bacteria' named entity 'pathogens' named entity 'direct examination' named entity 'antibiotic resistance genes' named entity 'CFU' named entity 'bacteria' named entity 'Staphylococcus aureus' named entity 'AST' named entity 'de-escalation' named entity 'fever' named entity 'VAP' named entity 'Proteus' named entity 'CFU' named entity 'viruses' named entity 'AST' named entity 'β-lactams' named entity 'empirical therapy' named entity 'atypical bacteria' named entity 'viruses' named entity 'Citrobacter' named entity 'nucleic acids' named entity 'community-acquired pneumonia' named entity 'De-escalation' named entity 'Medical Microbiology' named entity 'Rennes' named entity 'pathogens' named entity 'antibiotic' named entity 'Staphylococcus aureus' named entity 'community-acquired pneumonia' named entity 'PCR' named entity 'PCR' named entity 'antimicrobial' named entity 'randomized controlled trials' named entity 'PCR' named entity 'PCR' named entity 'Infectious Diseases' named entity 'HAP' named entity 'pathogens' named entity '8.5' named entity 'ETA' named entity 'Escherichia coli'

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