Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan.
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Pediatr Int. 2023 Jan-Dec;65(1):e15525. doi: 10.1111/ped.15525.
The coronavirus disease 2019 outbreak has prompted some hospitals to implement screening tests upon admission since 2020. FilmArray® Respiratory 2.1 Panel (FilmArray) is a multiplex polymerase chain reaction (PCR) test with high sensitivity and specificity for detecting respiratory pathogens. We aimed to assess the clinical influence of the routine use of FilmArray for pediatric patients, including those without symptoms suggestive of an infection.
We conducted a single-center retrospective observational study, which investigated patients aged ≤15 years who underwent FilmArray on admission in 2021. We collected the patients' epidemiological information, symptoms, and FilmArray results from their electronic health records.
A positive result was observed in 58.6% of patients admitted to the general ward or intensive care unit (ICU) but only in 1.5% of patients in the neonatal ward. Among the patients admitted to the general ward or ICU who tested positive, 93.3% had symptoms suggestive of infections, 44.6% had a sick contact before admission, and 70.5% had siblings. However, 62 (28.2%) out of 220 patients without the four (fever, respiratory, gastrointestinal, and dermal) symptoms also had positive results. Among them, 18 patients with adenovirus and three with respiratory syncytial virus were isolated to private rooms. However, 12 (57.1%) patients were discharged without symptoms suggestive of viral infection.
Multiplex PCR routine use for all inpatients may lead to excessive management of positive cases because FilmArray cannot quantify microorganisms. Thus, targets for testing should be considered carefully based on patients' symptoms and histories of sick contacts.
自 2020 年以来，由于新冠疫情的爆发，一些医院开始在入院时实施筛查检测。FilmArray® Respiratory 2.1 Panel（FilmArray）是一种用于检测呼吸道病原体的高灵敏度和特异性的多重聚合酶链反应（PCR）检测。我们旨在评估常规使用 FilmArray 对儿科患者（包括无感染症状的患者）的临床影响。
我们进行了一项单中心回顾性观察性研究，该研究调查了 2021 年入院时接受 FilmArray 检测的年龄≤15 岁的患者。我们从电子病历中收集了患者的流行病学信息、症状和 FilmArray 结果。
在普通病房或重症监护病房（ICU）住院的患者中，阳性结果的检出率为 58.6%，但在新生儿病房的患者中仅为 1.5%。在普通病房或 ICU 中阳性的患者中，93.3%有感染症状，44.6%在入院前有患病接触者，70.5%有兄弟姐妹。然而，在没有发热、呼吸、胃肠道和皮肤四种症状的 220 名患者中，仍有 62 名（28.2%）检测结果为阳性。其中，18 名患者感染了腺病毒，3 名患者感染了呼吸道合胞病毒，被隔离至私人病房。然而，有 12 名（57.1%）患者在没有病毒性感染症状的情况下出院。
对所有住院患者常规进行多重 PCR 检测可能会导致对阳性病例的过度管理，因为 FilmArray 无法定量检测微生物。因此，应根据患者的症状和患病接触者的病史，仔细考虑检测的目标。
