Reischl Anna Theresa, Schreiner Daniel, Poplawska Krystyna, Kidszun André, Zepp Fred, Gröndahl Britta, Gehring Stephan
Children's Hospital, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
J Clin Lab Anal. 2020 May;34(5):e23203. doi: 10.1002/jcla.23203. Epub 2020 Feb 7.
Children are commonly affected by respiratory tract infections. Based on clinical symptoms, laboratory evaluation, and imaging, the causative pathogen often cannot be delineated. Point-of-care-testing systems that provide an opportunity for fast detection of common viruses and some bacteria can therefore influence treatment's options. We aimed to examine whether the Biofire® FilmArray® has an effect on antibiotic treatment, duration of antibiotic therapy, and length of hospital stay within a pediatric cohort.
We included children who were admitted to inpatient treatment with an acute respiratory tract infection from 02/2017 to 04/2018 using the FA respiratory panel for pathogen detection. The study group data were compared to the retrospective data of children admitted from 02/2016 to 02/2017, using a proprietary multiplex RT-PCR.
A total of 322 children of the study group and 464 children of the control group were analyzed for clinical symptoms, laboratory findings, antibiotic treatment, and length of hospital stay. There was no significant reduction (P < .05) of antibiotic treatment and length of hospital stay. CRP, prehospital antibiotic treatment, antibiotic treatment, past medical history, age, and further pathogen detection showed a significant impact on antibiotic therapy, duration of antibiotic treatment, and length of hospital stay.
The use of the FA did not result in a significant reduction of antibiotic treatment or in length of hospital stay. Other parameters had a more significant impact. Therefore, we suggest that standard operation procedures with therapy guidelines are necessary to provide an effective application of POCT systems.
儿童常受呼吸道感染影响。基于临床症状、实验室评估和影像学检查，往往无法确定致病病原体。即时检测系统能够快速检测常见病毒和一些细菌，因此可能会影响治疗方案的选择。我们旨在研究Biofire® FilmArray®对儿科队列中的抗生素治疗、抗生素治疗持续时间和住院时间是否有影响。
我们纳入了2017年2月至2018年4月因急性呼吸道感染入院接受治疗的儿童，使用FA呼吸道检测板进行病原体检测。将研究组数据与2016年2月至2017年2月入院儿童的回顾性数据进行比较，后者使用的是一种专利多重逆转录聚合酶链反应。
共对研究组的322名儿童和对照组的464名儿童进行了临床症状、实验室检查结果、抗生素治疗和住院时间的分析。抗生素治疗和住院时间没有显著减少（P <.05）。C反应蛋白、院前抗生素治疗、抗生素治疗、既往病史、年龄和进一步的病原体检测对抗生素治疗、抗生素治疗持续时间和住院时间有显著影响。
使用FA并未显著减少抗生素治疗或缩短住院时间。其他参数有更显著的影响。因此，我们建议需要有治疗指南的标准操作程序，以有效应用即时检测系统。
