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Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection

BACKGROUND: We aimed to determine the impact of utilizing a rapid panel test of respiratory viral and atypical bacteria (FilmArray® Respiratory Panel, FA RP) on etiological diagnosis of acute lower respiratory infection (ALRI) and antimicrobial stewardship in critical care pediatric patients. METHOD...

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Autores principales: Brotons, Pedro, Villaronga, Miquel, Henares, Desirée, Armero, Georgina, Launes, Cristian, Jordan, Iolanda, Muñoz-Almagro, Carmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544565/
https://www.ncbi.nlm.nih.gov/pubmed/33041081
http://dx.doi.org/10.1016/j.eimc.2020.08.017
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author Brotons, Pedro
Villaronga, Miquel
Henares, Desirée
Armero, Georgina
Launes, Cristian
Jordan, Iolanda
Muñoz-Almagro, Carmen
author_facet Brotons, Pedro
Villaronga, Miquel
Henares, Desirée
Armero, Georgina
Launes, Cristian
Jordan, Iolanda
Muñoz-Almagro, Carmen
author_sort Brotons, Pedro
collection PubMed
description BACKGROUND: We aimed to determine the impact of utilizing a rapid panel test of respiratory viral and atypical bacteria (FilmArray® Respiratory Panel, FA RP) on etiological diagnosis of acute lower respiratory infection (ALRI) and antimicrobial stewardship in critical care pediatric patients. METHODS: Prospective cohort study of patients aged < 18 years with clinical diagnosis of ALRI that were admitted to the Pediatric Intensive Care Unit (PICU) of Hospital Sant Joan de Deu (Barcelona, Spain) during December 2015–February 2017. Patients were diagnosed by FA RP and by a bundle of routine microbiological assays. RESULTS: ALRI viral and bacterial etiology was confirmed by a composite reference standard of routine microbiological assays in 72 (55.4%) and 15 (11.5%) respiratory samples, respectively, that were collected from 130 children (median age, 3.5 months, IQR 1.1–14.8 months; 54.6% male). Comparatively, FA RP use increased etiological confirmation of ALRI in up to 123 (94.6%) samples (p < 0.001) but only determined a bacterial origin in 2 (1.5%). Availability of diagnostic results before patient discharge from the PICU rose from 65.4 to 38.5% (p < 0.001). Use of the new panel test directly influenced antimicrobial stewardship in 11 (8.4%) episodes, leading to discontinuation of antiviral drugs (n = 5), administration of targeted antibiotics (n = 3), antiviral therapy start (n = 2) and both targeted antibiotic administration and discontinuation of antiviral drugs (n = 1). CONCLUSION: FA RP contributed to improve etiological diagnosis of ALRI in a timely manner while enhancing a more rational use of antimicrobial drugs in critical care pediatric patients.
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spelling pubmed-75445652020-10-09 Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection Brotons, Pedro Villaronga, Miquel Henares, Desirée Armero, Georgina Launes, Cristian Jordan, Iolanda Muñoz-Almagro, Carmen Enferm Infecc Microbiol Clin Original Article BACKGROUND: We aimed to determine the impact of utilizing a rapid panel test of respiratory viral and atypical bacteria (FilmArray® Respiratory Panel, FA RP) on etiological diagnosis of acute lower respiratory infection (ALRI) and antimicrobial stewardship in critical care pediatric patients. METHODS: Prospective cohort study of patients aged < 18 years with clinical diagnosis of ALRI that were admitted to the Pediatric Intensive Care Unit (PICU) of Hospital Sant Joan de Deu (Barcelona, Spain) during December 2015–February 2017. Patients were diagnosed by FA RP and by a bundle of routine microbiological assays. RESULTS: ALRI viral and bacterial etiology was confirmed by a composite reference standard of routine microbiological assays in 72 (55.4%) and 15 (11.5%) respiratory samples, respectively, that were collected from 130 children (median age, 3.5 months, IQR 1.1–14.8 months; 54.6% male). Comparatively, FA RP use increased etiological confirmation of ALRI in up to 123 (94.6%) samples (p < 0.001) but only determined a bacterial origin in 2 (1.5%). Availability of diagnostic results before patient discharge from the PICU rose from 65.4 to 38.5% (p < 0.001). Use of the new panel test directly influenced antimicrobial stewardship in 11 (8.4%) episodes, leading to discontinuation of antiviral drugs (n = 5), administration of targeted antibiotics (n = 3), antiviral therapy start (n = 2) and both targeted antibiotic administration and discontinuation of antiviral drugs (n = 1). CONCLUSION: FA RP contributed to improve etiological diagnosis of ALRI in a timely manner while enhancing a more rational use of antimicrobial drugs in critical care pediatric patients. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. 2020-10-09 /pmc/articles/PMC7544565/ /pubmed/33041081 http://dx.doi.org/10.1016/j.eimc.2020.08.017 Text en © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Brotons, Pedro
Villaronga, Miquel
Henares, Desirée
Armero, Georgina
Launes, Cristian
Jordan, Iolanda
Muñoz-Almagro, Carmen
Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title_full Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title_fullStr Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title_full_unstemmed Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title_short Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
title_sort clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544565/
https://www.ncbi.nlm.nih.gov/pubmed/33041081
http://dx.doi.org/10.1016/j.eimc.2020.08.017
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