Comparison of a Point-of-Care FilmArray Test to Standard-of-Care Microbiology Test in Diagnosis of Healthcare Associated Infections in a Tertiary Care Pediatric Intensive Care Unit.
| Autor: | El-Nawawy AA; Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt., Antonios MA; Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt., Tawfik ME; Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt., Meheissen MA; Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Alexandria 21512, Egypt. |
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| Jazyk: | angličtina |
| Zdroj: | Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2022 Mar 27; Vol. 11 (4). Date of Electronic Publication: 2022 Mar 27. |
| DOI: | 10.3390/antibiotics11040453 |
| Abstrakt: | Background: Rapid and accurate identification of healthcare associated pathogens is crucial for early diagnosis and treatment of infections. This study aimed to assess the performance of a point-of-care multiplex polymerase chain reaction (PCR) in diagnosis of pathogens and their antibiotic resistance genes in bloodstream infections, pneumonia and meningitis/encephalitis in a pediatric intensive care unit (PICU). Methods: A retrospective cross-sectional study was conducted on pediatric patients diagnosed with healthcare associated infections at Alexandria University PICU, Egypt. A total of 111 samples from 98 patients were subjected simultaneously to standard-of-care microbiology testing (SOCMT) and molecular testing by BioFire multiplex PCR. Results: In comparison to SOCMT, the BioFire FilmArray ® had a better diagnostic yield with broncho-alveolar lavage (BAL) (45 vs. 21) and cerebrospinal fluid (CSF) samples (five vs. none) ( p ≤ 0.0001). Klebsiella pneumoniae was the most common pathogen in BAL ( n = 19 by BioFire, n = 9 by SOCMT) and blood ( n = 7, by SOCMT and BioFire) samples, while Streptococcus pneumoniae was the most common in CSF samples. BioFire showed 95.8% overall percent agreement, 100% positive percent agreement and 95.6% negative percent agreement with SOCMT. All phenotypically confirmed resistant isolates had resistance genes by the BioFire FilmArray ® (100%). The turnaround time (TAT) of positive results by the FilmArray panels was 1-1.5 h in comparison to 48-72 h by SOCMT ( p ≤ 0.001). Conclusions: The results of the current study confirm the utility of the BioFire FilmArray ® in making early decisions regarding patients' diagnosis and management of infection in the PICU, in terms of rapid TAT and appropriate antimicrobial use. |
| Databáze: | MEDLINE |
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