Background

Multiplexed molecular rapid diagnostic tests (RDTs) may allow for rapid and accurate diagnosis of the microbial etiology of pneumonia. However, little data are available on multiplexed RDTs in pneumonia and their impact on clinical practice.

Methods

This retrospective study analyzed 659 hospitalized patients for microbiological diagnosis of suspected pneumonia.

Results

The overall sensitivity of the Unyvero LRT Panel was 85.7% (95% CI 82.3–88.7) and the overall specificity was 98.4% (95% CI 98.2–98.7) with a negative predictive value of 97.9% (95% CI 97.6–98.1). The LRT Panel result predicted no change in antibiotics in 12.4% of cases but antibiotic de-escalation in 65.9% (405/615) of patients, of whom 278/405 (69%) had unnecessary MRSA coverage and 259/405 (64%) had unnecessary P. aeruginosa coverage.

Interpretation

In hospitalized adults with suspected pneumonia, use of an RDT on respiratory samples can allow for early adjustment of initial antibiotics, most commonly de-escalation.

中文翻译：

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疑似肺炎中抗生素管理的多重聚合酶链反应分析。

背景

多重分子快速诊断检测（RDT）可以快速，准确地诊断肺炎的微生物病因。但是，关于肺炎中多重RDT及其对临床实践的影响的数据很少。

方法

这项回顾性研究分析了659名住院患者的可疑肺炎的微生物学诊断。

结果

Unyvero LRT专家组的总体敏感性为85.7％（95％CI 82.3-88.7），总体特异性为98.4％（95％CI 98.2-98.7），阴性预测值为97.9％（95％CI 97.6-98.1）。 。LRT小组的结果预测，在12.4％的病例中抗生素没有变化，但在65.9％（405/615）的患者中抗生素降级，其中278/405（69％）的患者不需要MRSA覆盖，而259/405（64％） ）有不必要的铜绿假单胞菌覆盖。

解释

在怀疑患有肺炎的住院成人中，在呼吸道样本上使用RDT可以早期调整初始抗生素，最常见的是降级。