Evaluation of a Commercial Multiplexed Molecular Lower Respiratory Panel at a Tertiary Care Cancer Center
| Autor: | Peter A. Mead, N. Esther Babady, Melvilí Cintrón, Rawlica Sumner, Tracy McMillen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Microbiological culture medicine.drug_class Antibiotics Gastroenterology Sensitivity and Specificity Pathology and Forensic Medicine Tertiary Care Centers Internal medicine Neoplasms Drug Resistance Bacterial medicine Pneumonia Bacterial Humans Respiratory Tract Infections Aged Aged 80 and over medicine.diagnostic_test Bacteria business.industry Bacterial pneumonia Cancer Regular Article Middle Aged medicine.disease Anti-Bacterial Agents Pneumonia Bronchoalveolar lavage medicine.anatomical_structure Cohort Molecular Medicine business Bronchoalveolar Lavage Fluid Multiplex Polymerase Chain Reaction Respiratory tract |
| Zdroj: | J Mol Diagn |
| Popis: | Diagnosis and management of bacterial pneumonia still relies on bacterial culture and antimicrobial susceptibility testing. The Unyvero Lower Respiratory Tract panel (LRT) is a multiplex molecular assay that provides results within approximately 4.5 hours. This study evaluated the analytical performance of the LRT on bronchoalveolar lavage (BAL) fluids and bronchial washings (BW) in a cancer patient population and retrospectively determined clinical impact on therapy. Sensitivity and specificity of LRT on BAL and BW compared with bacterial culture and susceptibilities were calculated. Chart reviews were performed to determine whether antibiotic management would have changed based on the LRT results. A total of 113 BAL and 123 BW respiratory samples from 191 patients were included. The overall sensitivity and specificity were 91.7% (95% CI, 77.5%-98.3%) and 92.0% (95% CI, 87.3%-95.4%), respectively. Staphylococcus aureus was the most common target detected (n = 21) with 89.5% (95% CI, 66.8%-98.7%) sensitivity and 98.2% (95% CI, 95.4%-99.5%) specificity. Based on availability of LRT results, 4.8% of patients could have been de-escalated faster. The LRT demonstrated an overall high accuracy for the detection of common bacteria associated with pneumonia. In this cancer inpatient cohort, treatment adjustment based on LRT results would have occurred in a small number of cases. Larger studies are necessary to understand the real-world impact within specific high-risk populations. |
| Databáze: | OpenAIRE |
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