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快速多重聚合酶链反应对 COVID-19 阳性重症监护病房住院患者抗生素治疗管理的影响。

Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit.

机构信息

Université de Paris, INSERM, IAME, F-75006, Paris, France.

Service de Bactériologie, Hôpital Bichat Claude Bernard, AP-HP Nord, Université de Paris, 46 rue Henri Huchard, 75877, Paris Cedex 18, France.

出版信息

Eur J Clin Microbiol Infect Dis. 2021 Oct;40(10):2227-2234. doi: 10.1007/s10096-021-04213-6. Epub 2021 Mar 17.

Abstract

Because the diagnosis of co/superinfection in COVID-19 patients is challenging, empirical antibiotic therapy is frequently initiated until microbiological analysis results. We evaluated the performance and the impact of the BioFire® FilmArray® Pneumonia plus Panel on 112 respiratory samples from 67 COVID-19 ICU patients suspected of co/superinfections. Globally, the sensitivity and specificity of the test were 89.3% and 99.1%, respectively. Positive tests led to antibiotic initiation or adaptation in 15% of episodes and de-escalation in 4%. When negative, 28% of episodes remained antibiotic-free (14% no initiation, 14% withdrawal). Rapid multiplex PCRs can help to improve antibiotic stewardship by administering appropriate antibiotics earlier and avoiding unnecessary prescriptions.

摘要

由于 COVID-19 患者合并/继发感染的诊断具有挑战性,因此在获得微生物分析结果之前,常经验性地开始使用抗生素治疗。我们评估了 BioFire® FilmArray® Pneumonia plus Panel 在 112 份来自 67 名 COVID-19 ICU 患者疑似合并/继发感染的呼吸道样本中的性能和影响。总体而言,该检测的敏感性和特异性分别为 89.3%和 99.1%。阳性检测结果导致 15%的病例开始使用抗生素或调整抗生素,4%的病例减少使用。当检测结果为阴性时,28%的病例无需使用抗生素(14%无需开始使用,14%停止使用)。快速多重 PCR 可通过更早地使用适当的抗生素和避免不必要的处方来帮助改善抗生素管理。

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