Rezkalla Joshua, Hoover Susan E, Hsu Jennifer, Lamfers Randall
Department of Medicine-Pediatrics, University of California Los Angeles, Los Angeles, California.
Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2019 Feb;72(2):63-66.
Community-acquired pneumonia (CAP) is a common and costly problem in U.S. healthcare. A major challenge in development of targeted treatment strategies has been limitations in diagnostic testing to confirm specific pathogens, including viruses. The recent and widespread use of multiplex polymerase chain reaction (mPCR) to identify pathogens has created an opportunity to improve diagnostic testing and subsequent antibiotic stewardship. We performed a retrospective cohort study examining 233 inpatients with pneumonia of which 70 patients underwent testing with mPCR. A specific pathogen was identified by mPCR in 24 percent of these patients and there was a statistically significant decrease in antibiotic use between patients who tested negative (average 8.3 days of antibiotics) versus patients who tested positive (average 4.9 days of antibiotics). This highlights the potential utility of mPCR implementation as an antibiotic stewardship strategy.
社区获得性肺炎（CAP）在美国医疗保健领域是一个常见且代价高昂的问题。制定针对性治疗策略的一个主要挑战在于诊断检测方面存在局限性，难以确认包括病毒在内的特定病原体。近期多重聚合酶链反应（mPCR）被广泛用于识别病原体，这为改进诊断检测及后续抗生素管理创造了契机。我们开展了一项回顾性队列研究，对233例肺炎住院患者进行了检查，其中70例患者接受了mPCR检测。在这些患者中，mPCR检测出特定病原体的比例为24%，检测结果为阴性的患者（平均使用抗生素8.3天）与检测结果为阳性的患者（平均使用抗生素4.9天）相比，抗生素使用量有统计学意义上的显著下降。这凸显了实施mPCR作为抗生素管理策略的潜在效用。
