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呼吸道病毒检测板聚合酶链反应检测周转时间对呼吸道病毒感染患者住院时间和抗生素使用的影响。

Impact of Respiratory Viral Panel Polymerase Chain Reaction Assay Turnaround Time on Length of Stay and Antibiotic Use in Patients With Respiratory Viral Illnesses.

作者信息

Choi Sebastian, Kabir Rubiya, Gautam-Goyal Pranisha, Malhotra Prashant

机构信息

North Shore University Hospital, Manhasset, NY, USA.

出版信息

Hosp Pharm. 2017 Oct;52(9):640-644. doi: 10.1177/0018578717731573. Epub 2017 Oct 10.

DOI:10.1177/0018578717731573
PMID:29276302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5735740/
Abstract

Respiratory viral illnesses account for many hospitalizations and inappropriate antibiotic use. Respiratory viral panels by polymerase chain reaction (RVP-PCR) provide a reliable means of diagnosis. In 2015, the RVP-PCR assay at our institution was switched from respiratory viral panel (RVP) to rapid respiratory panel (rapid RP), which has a faster turnaround time (24 hours vs 12 hours, respectively). The purpose of this study was to evaluate the effect of RVP-PCR tests on duration of antibiotic use and length of stay (LOS) in hospitalized patients. We performed a retrospective chart review of patients who had a RVP-PCR ordered within a 1-year time period before and after the assay switch. Patients who were pregnant, had received antibiotics within 30 days prior to admission, were not discharged, or had not completed antibiotics by end of study period were excluded. Data were obtained from a total of 140 patients (70 in each group). Of these, 25 (35.7%) in the RVP group and 28 (40.0%) in the rapid RP group had a positive result. The median LOS was 4.5 days (IQR, 3-9 days) in the RVP group and 5 days (IQR, 3-9 days) in the rapid RP group ( = .78). The median duration of antibiotic use was 4 days (IQR, 2-7 days) in the RVP group and 5 days (IQR, 1-7 days) in the rapid RP group ( = .8). Despite faster turnaround time, there was no significant difference in duration of antibiotic use, or LOS between the RVP and rapid RP groups.

摘要

呼吸道病毒感染导致许多患者住院以及抗生素的不当使用。聚合酶链反应(PCR)检测的呼吸道病毒检测板为诊断提供了一种可靠的方法。2015年,我们机构的PCR检测呼吸道病毒检测板从呼吸道病毒检测板(RVP)切换为快速呼吸道检测板(快速RP),后者的周转时间更快(分别为24小时和12小时)。本研究的目的是评估PCR检测呼吸道病毒检测对住院患者抗生素使用时长和住院时间(LOS)的影响。我们对检测板切换前后1年内进行PCR检测呼吸道病毒检测的患者进行了回顾性病历审查。排除怀孕、入院前30天内接受过抗生素治疗、未出院或在研究期结束时未完成抗生素治疗的患者。总共从140名患者(每组70名)中获取数据。其中,RVP组25名(35.7%)和快速RP组28名(40.0%)检测结果呈阳性。RVP组的中位住院时间为4.5天(IQR,3 - 9天),快速RP组为5天(IQR,3 - 9天)( = 0.78)。RVP组抗生素使用的中位时长为4天(IQR,2 - 7天),快速RP组为5天(IQR,1 - 7天)( = 0.8)。尽管周转时间更快,但RVP组和快速RP组在抗生素使用时长或住院时间方面没有显著差异。

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本文引用的文献

1
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Hosp Pediatr. 2014 Nov;4(6):372-6. doi: 10.1542/hpeds.2014-0018.
2
Comparison of the Biofire FilmArray RP, Genmark eSensor RVP, Luminex xTAG RVPv1, and Luminex xTAG RVP fast multiplex assays for detection of respiratory viruses.比较生物梅里埃 FilmArray RP、基因标记 eSensor RVP、罗氏 Luminex xTAG RVPv1 和罗氏 Luminex xTAG RVP fast 多重检测试剂盒用于呼吸道病毒检测。
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Role of a respiratory viral panel in the clinical management of pediatric inpatients.呼吸道病毒-panel 在儿科住院患者临床管理中的作用。
Pediatr Infect Dis J. 2013 May;32(5):467-72. doi: 10.1097/INF.0b013e318284b146.
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The diagnosis of viral respiratory disease in older adults.老年人病毒性呼吸道疾病的诊断。
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Cost-effectiveness of rapid diagnosis of viral respiratory tract infections in pediatric patients.儿科患者病毒性呼吸道感染快速诊断的成本效益
J Clin Microbiol. 1997 Jun;35(6):1579-81. doi: 10.1128/jcm.35.6.1579-1581.1997.