A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia

Chiagozie Pickens; Richard G. Wunderink; Chao Qi; Haritha Mopuru; Helen Donnelly; Kimberly Powell; Matthew D. Sims

doi:10.1016/j.diagmicrobio.2020.115179

A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia

Chiagozie Pickens^*, Richard G. Wunderink, Chao Qi, Haritha Mopuru, Helen Donnelly, Kimberly Powell, Matthew D. Sims

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

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.

Original language	English (US)
Article number	115179
Journal	Diagnostic Microbiology and Infectious Disease
Volume	98
Issue number	4
DOIs	https://doi.org/10.1016/j.diagmicrobio.2020.115179
State	Published - Dec 2020

Keywords

Antimicrobial stewardship
Bacteria
Multiplexed PCR
Pneumonia
Rapid diagnostic test

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diagmicrobio.2020.115179

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title = "A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia",

abstract = "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.",

keywords = "Antimicrobial stewardship, Bacteria, Multiplexed PCR, Pneumonia, Rapid diagnostic test",

author = "Chiagozie Pickens and Wunderink, {Richard G.} and Chao Qi and Haritha Mopuru and Helen Donnelly and Kimberly Powell and Sims, {Matthew D.}",

note = "Funding Information: Funding statement: This work is supported by the National Institute of Health Institutional Training Grant ( 3T32HL76139-13S2 ) and by NIH / NIAID grant U19AI135964 . Funding Information: Funding statement: This work is supported by the National Institute of Health Institutional Training Grant (3T32HL76139-13S2) and by NIH/NIAID grant U19AI135964. Publisher Copyright: {\textcopyright} 2020",

year = "2020",

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doi = "10.1016/j.diagmicrobio.2020.115179",

language = "English (US)",

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T1 - A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia

AU - Pickens, Chiagozie

AU - Wunderink, Richard G.

AU - Qi, Chao

AU - Mopuru, Haritha

AU - Donnelly, Helen

AU - Powell, Kimberly

AU - Sims, Matthew D.

N1 - Funding Information: Funding statement: This work is supported by the National Institute of Health Institutional Training Grant ( 3T32HL76139-13S2 ) and by NIH / NIAID grant U19AI135964 . Funding Information: Funding statement: This work is supported by the National Institute of Health Institutional Training Grant (3T32HL76139-13S2) and by NIH/NIAID grant U19AI135964. Publisher Copyright: © 2020

PY - 2020/12

Y1 - 2020/12

N2 - 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.

AB - 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.

KW - Antimicrobial stewardship

KW - Bacteria

KW - Multiplexed PCR

KW - Pneumonia

KW - Rapid diagnostic test

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A multiplex polymerase chain reaction assay for antibiotic stewardship in suspected pneumonia

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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