Youssef Nour, Boutros Celina F, Dakroub Fatima, Akl Fata, Reslan Lina, Finianos Marc, Moumneh Mohammad Bahij M, Dargham Tarek Bou, Zein Zeinab El, Haddara Amani, Korman Rawan, Khafaja Sarah, Matar Ghassan, Araj George F, Dbaibo Ghassan S
Center for Infectious Diseases Research (CIDR) and World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Front Cell Infect Microbiol. 2025 Aug 7;15:1619640. doi: 10.3389/fcimb.2025.1619640. eCollection 2025.
The identification of bacterial pathogens in the clinical setting is essential for providing optimal care and improving outcomes. The primary objective of this study was to assess the performance of the 16S test in bacterial identification from different samples and determine its impact on clinical outcomes.
This was a retrospective study of patient samples collected from all age-groups at the American University of Beirut Medical Center (AUBMC), from May 2016 to December 2022. Descriptive statistics were conducted to calculate the 16S test positivity rate and to describe the different types of organisms. Univariate analyses were performed to study the clinical impact of the 16S test and its comparison to the conventional bacterial culture among different characteristics. A p ≤ 0.05 was considered statistically significant.
A total of 1489 specimens were submitted for the 16S test during the study period. Of the submitted tests, 395 (26%) had bacteria identified by the 16S test and/or culture. Out of the culture negative/16S positive group, the majority were from specimens collected from the skin and soft tissue system (24 out of 92, 26.1%). This was followed by musculoskeletal specimens (15 out of 92, 16.3%), and central nervous system specimens (14 out of 92, 15.2%). Pus samples had a positivity rate of 66.3% with 5 times higher odds of being positive compared to non-pus samples (25%). Overall, there were 260 identified organisms by 16S test of which the most detected organisms were spp, spp. and The results revealed that 16S testing impacted management in 45.9% of the cases (83/181) showing a change in management. Antibiotic escalation was applied in 31.3% of cases (26/83). Antibiotic de-escalation occurred in 41% of cases (34/83). A change in the treating diagnosis was noted in 26.5% of cases (22/83).
Identification of pathogens using the 16S test in combination with conventional cultures is essential in clinical diagnostics and management of infectious diseases to provide targeted therapy and improve antimicrobial stewardship. Shorter turnaround time, improved patient management, and cost-effectiveness are key factors to consider when advocating for the broader adoption of 16S testing.
在临床环境中识别细菌病原体对于提供最佳治疗和改善治疗结果至关重要。本研究的主要目的是评估16S检测在从不同样本中鉴定细菌方面的性能，并确定其对临床结果的影响。
这是一项对2016年5月至2022年12月在美国贝鲁特美国大学医学中心（AUBMC）收集的各年龄组患者样本的回顾性研究。进行描述性统计以计算16S检测阳性率并描述不同类型的生物体。进行单变量分析以研究16S检测的临床影响及其在不同特征下与传统细菌培养的比较。p≤0.05被认为具有统计学意义。
在研究期间，共有1489份标本进行了16S检测。在提交的检测中，395份（26%）通过16S检测和/或培养鉴定出细菌。在培养阴性/16S阳性组中，大多数来自皮肤和软组织系统的标本（92份中的24份，26.1%）。其次是肌肉骨骼标本（92份中的15份，16.3%）和中枢神经系统标本（92份中的14份，15.2%）。脓液样本的阳性率为66.3%，阳性几率是非脓液样本（25%）的5倍。总体而言，通过16S检测鉴定出260种生物体，其中检测到最多的生物体是 spp、 spp和 。结果显示，16S检测在45.9%的病例（83/181）中影响了管理，显示出管理上的变化。31.3%的病例（26/83）应用了抗生素升级。41%的病例（34/83）发生了抗生素降级。26.5%的病例（22/83）注意到治疗诊断发生了变化。
在传染病的临床诊断和管理中使用16S检测结合传统培养来鉴定病原体对于提供靶向治疗和改善抗菌药物管理至关重要。在倡导更广泛采用16S检测时，周转时间缩短、患者管理改善和成本效益是需要考虑的关键因素。
