Clinical impact of rapid molecular detection of respiratory pathogens in patients with acute respiratory infection

Autor: Débora Natalia Marcone, J. Ekstrom, C. O'Farrell, S. Vidaurreta, A. Seoane, Guadalupe Carballal, Marcela Echavarria, C. Videla, M. Querci, M. Ypas
Rok vydání: 2018
Předmět:
Male
0301 basic medicine
FilmArray
Antibiotics
Fluorescent Antibody Technique
Inappropriate Prescribing
Medicina Clínica
chemistry.chemical_compound
0302 clinical medicine
Prospective Studies
030212 general & internal medicine
Respiratory system
CLINICAL IMPACT
Child
Respiratory Tract Infections
Oligonucleotide Array Sequence Analysis
Respiratory infection
Middle Aged
Respiratory pathogens
Infectious Diseases
Virus Diseases
Child
Preschool
Acute Disease
Viruses
Female
Emergency Service
Hospital
ANTIBIOTICS
MULTIPLEX PCR
Adult
medicine.medical_specialty
Oseltamivir
CIENCIAS MÉDICAS Y DE LA SALUD
Adolescent
medicine.drug_class
030106 microbiology
Article
Young Adult
03 medical and health sciences
FILMARRAY
RESPIRATORY INFECTIONS
Sistema Respiratorio
Virology
Internal medicine
medicine
Humans
In patient
Medical prescription
Aged
Clinical impact
business.industry
Respiratory infections
Infant
Emergency department
Multiplex PCR
chemistry
OSELTAMIVIR
business
Multiplex Polymerase Chain Reaction
Zdroj: Journal of Clinical Virology
ISSN: 1386-6532
DOI: 10.1016/j.jcv.2018.09.009
Popis: Highlights • Diagnosis with FilmArray-RP was associated with changes in medical management. • Accurate and rapid diagnosis decreased antibiotic use and complementary studies, and improved oseltamivir use. • The multiplex PCR respiratory panel permitted a high viral detection rate not only in children but in adults.
Background Acute respiratory infections (ARI) are a leading cause of morbidity and mortality worldwide. There is a need to demonstrate the clinical impact of using the new, rapid and sensitive molecular assays in prospectively designed studies. Objectives To study the impact on medical management of a rapid molecular assay in patients with respiratory infections. Study design A prospective, randomized, non-blinded study was performed in patients presenting to the Emergency Department during two respiratory seasons (2016–2017). Diagnosis was performed by FilmArray Respiratory Panel (FilmArray-RP) or by immunofluorescence assay (IFA). Results A total of 432 patients (156 children and 276 adults) were analyzed. Diagnosis with FilmArray-RP was associated with significant changes in medical management including withholding antibiotic prescriptions (OR:15.52, 95%CI:1.99–120.83 in adults and OR:12.23, 95%CI:1.56–96.09 in children), and reduction in complementary studies in children (OR:9.64, 95%CI:2.13–43.63) compared to IFA. Decrease in oseltamivir prescriptions was significantly higher in adults in the FilmArray-RP group (p = 0.042; OR:1.19, 95%CI:0.51-2.79) compared to adults managed with IFA. Diagnostic yield was significantly higher by FilmArray-RP (81%) than by IFA (31%)(p
Databáze: OpenAIRE
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