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 journalArticlepeer-review

25 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 languageEnglish (US)
Article number115179
JournalDiagnostic Microbiology and Infectious Disease
Volume98
Issue number4
DOIs
StatePublished - Dec 2020

Funding

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

Keywords

  • Antimicrobial stewardship
  • Bacteria
  • Multiplexed PCR
  • Pneumonia
  • Rapid diagnostic test

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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