FilmArray®肺炎加项检测板用于儿童呼吸机相关性肺炎病原体检测的评估及其对治疗管理的影响。
Evaluation PCR panel of the FilmArray® pneumonia plus for pathogen detection of ventilator-associated pneumonia in children and its impact on therapeutic management.
作者信息
Debbagh Fayrouz, Ben Houmich Toufik, Guennouni Morad, Sahraoui Houssameddine, Hanchi Asma Lamrani, Mouaffak Youssef, Younous Said, Soraa Nabila
机构信息
Laboratory of Microbiology, Faculty of Medicine and Pharmacy, Mohamed VI University Hospital Center, Cadi Ayyad University, Marrakesh, Morocco.
Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences of Settat, Hassan First University of Settat, Settat, Morocco.
出版信息
Iran J Microbiol. 2023 Feb;15(1):19-26. doi: 10.18502/ijm.v15i1.11914.
BACKGROUND AND OBJECTIVES
Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in pediatric intensive care units. The aim of this study was to evaluate the contribution of multiplex PCR in the diagnosis of VAP and its impact on the clinical and prognostic outcome of children in the ICU.
MATERIALS AND METHODS
This is a prospective observational study from March to November 2021, including bronchial samples collected from 38 intubated children hospitalized in ICU. The detection of respiratory pathogens was performed by the FilmArray® Pneumonia Panel plus (FAPP).
RESULTS
Multiplex PCR (mPCR) detected exclusively 46 potentially pathogenic bacteria, giving a sensitivity of 93%, specificity of 90%, negative predictive value of 100%, and positive predictive value of 23%. Overall, the sensitivity of mPCR was higher for Gram-negative bacteria (100%) than Gram-positive (92%). Bacterial etiology was the most frequent (69.3%), represented mainly by (11.4%), followed by viral etiology (30.7%), with Rhinovirus/Enterovirus as the most prevalent virus. FAPP enabled a change in antibiotic therapy in 39.5% of the patients, with a 73.3% survival rate.
CONCLUSION
This study highlights the importance of mPCR in diagnosing VAP and improving antimicrobial therapy.
背景与目的
呼吸机相关性肺炎（VAP）是儿科重症监护病房中第二常见的医院感染。本研究的目的是评估多重聚合酶链反应（PCR）在VAP诊断中的作用及其对ICU中儿童临床和预后结果的影响。
材料与方法
这是一项于2021年3月至11月进行的前瞻性观察性研究，纳入了从ICU住院的38名插管儿童采集的支气管样本。通过FilmArray®肺炎检测板升级版（FAPP）进行呼吸道病原体检测。
结果
多重PCR（mPCR）仅检测到46种潜在病原菌，灵敏度为93%，特异性为90%，阴性预测值为100%，阳性预测值为23%。总体而言，mPCR对革兰氏阴性菌的灵敏度（100%）高于革兰氏阳性菌（92%）。细菌病因最为常见（69.3%），主要由[此处原文缺失具体细菌名称]（11.4%）引起，其次是病毒病因（30.7%），其中鼻病毒/肠道病毒是最常见的病毒。FAPP使39.5%的患者抗生素治疗方案得以改变，生存率为73.3%。
结论
本研究强调了mPCR在诊断VAP和改善抗菌治疗方面的重要性。
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