Department of Microbiology and Pharmacy, Beaumont Hospital, Dublin, Ireland.
Department of Microbiology and Pharmacy, Beaumont Hospital, Dublin, Ireland.
J Hosp Infect. 2018 Jun;99(2):148-152. doi: 10.1016/j.jhin.2017.08.016. Epub 2017 Aug 21.
Empiric broad-spectrum antimicrobial therapy frequently results in culture-negative specimens making rationalization of therapy difficult. We retrospectively reviewed 16S rRNA polymerase chain reaction (PCR) results from 78 specimens in 60 patients. 16S rRNA was detected in 28 (47%) patients with de-escalation of therapy in five (21%). Microbial DNA was not detected in 32 (53%) patients with antimicrobials discontinued in two (8%). Neurosurgical patients had a higher proportion of positive results (53% vs 34%) and treatment rationalizations (17% vs 12%). In specific patient groups, 16s rRNA PCR is a useful antimicrobial stewardship tool for targeting antimicrobial therapy.
经验性广谱抗菌治疗常导致培养阴性标本，使治疗合理化变得困难。我们回顾性分析了 60 例患者 78 份标本的 16S rRNA 聚合酶链反应（PCR）结果。28 例（47%）患者 16S rRNA 阳性，5 例（21%）患者治疗降级。32 例（53%）患者微生物 DNA 未检出，2 例（8%）患者停用抗菌药物。神经外科患者阳性结果（53% vs 34%）和治疗合理化比例（17% vs 12%）更高。在特定患者群体中，16s rRNA PCR 是一种有用的抗菌药物管理工具，可靶向抗菌治疗。
