{Reference Type}: Journal Article
{Title}: Clinical impact of rapid viral respiratory panel testing on pediatric critical care of patients with acute lower respiratory infection.
{Author}: Brotons P;Villaronga M;Henares D;Armero G;Launes C;Jordan I;Muñoz-Almagro C;
{Journal}: Enferm Infecc Microbiol Clin (Engl Ed)
{Volume}: 0
{Issue}: 0
{Year}: Oct 2020 8
暂无{DOI}: 10.1016/j.eimc.2020.08.017
{Abstract}: <B>BACKGROUND: </B>We aimed to determine the impact of utilizing a rapid panel test of respiratory viral and atypical bacteria (FilmArray® Respiratory Panel, FA RP) on etiological diagnosis of acute lower respiratory infection (ALRI) and antimicrobial stewardship in critical care pediatric patients.<BR><B>METHODS: </B>Prospective cohort study of patients aged<18 years with clinical diagnosis of ALRI that were admitted to the Pediatric Intensive Care Unit (PICU) of Hospital Sant Joan de Deu (Barcelona, Spain) during December 2015-February 2017. Patients were diagnosed by FA RP and by a bundle of routine microbiological assays.<BR><B>RESULTS: </B>ALRI viral and bacterial etiology was confirmed by a composite reference standard of routine microbiological assays in 72 (55.4%) and 15 (11.5%) respiratory samples, respectively, that were collected from 130 children (median age, 3.5 months, IQR 1.1-14.8 months; 54.6% male). Comparatively, FA RP use increased etiological confirmation of ALRI in up to 123 (94.6%) samples (p<0.001) but only determined a bacterial origin in 2 (1.5%). Availability of diagnostic results before patient discharge from the PICU rose from 65.4 to 38.5% (p<0.001). Use of the new panel test directly influenced antimicrobial stewardship in 11 (8.4%) episodes, leading to discontinuation of antiviral drugs (n=5), administration of targeted antibiotics (n=3), antiviral therapy start (n=2) and both targeted antibiotic administration and discontinuation of antiviral drugs (n=1).<BR><B>CONCLUSIONS: </B>FA RP contributed to improve etiological diagnosis of ALRI in a timely manner while enhancing a more rational use of antimicrobial drugs in critical care pediatric patients.