The clinical impact of PCR-based point-of-care diagnostic in respiratory tract infections in children
The clinical impact of PCR-based point-of-care diagnostic in respiratory tract infections in children
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DOI：
10.1002/jcla.23203
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发表时间：
2020-02-07
影响因子：
2.7
通讯作者：
Gehring, Stephan
中科院分区：
文献类型：
--
作者：
Reischl, Anna Theresa;Schreiner, Daniel;Gehring, Stephan
背景 儿童通常受到呼吸道感染的影响。根据临床症状、实验室评估和影像学检查，通常无法确定致病病原体。因此，即时检测系统可以快速检测常见病毒和某些细菌，从而影响治疗选择。我们的目的是在儿科队列中检查 Biofire (R) FilmArray (R) 是否对抗生素治疗、抗生素治疗持续时间和住院时间有影响。 方法 我们纳入了 2017 年 2 月至 2018 年 4 月因急性呼吸道感染住院治疗的儿童，使用 FA 呼吸系统检测进行病原体检测。使用专有的多重RT-PCR将研究组数据与2016年2月至2017年2月入院儿童的回顾性数据进行比较。结果对研究组322名儿童和对照组464名儿童的临床症状、实验室检查结果、抗生素治疗和住院时间进行了分析。抗生素治疗和住院时间没有显着减少（P < .05）。 CRP、院前抗生素治疗、抗生素治疗、既往病史、年龄和进一步病原体检测对抗生素治疗、抗生素治疗持续时间和住院时间有显着影响。结论 FA 的使用并没有导致抗生素治疗或住院时间的显着减少。其他参数有更显着的影响。因此，我们建议标准操作程序和治疗指南对于提供 POCT 系统的有效应用是必要的。
Background Children are commonly affected by respiratory tract infections. Based on clinical symptoms, laboratory evaluation, and imaging, the causative pathogen often cannot be delineated. Point-of-care-testing systems that provide an opportunity for fast detection of common viruses and some bacteria can therefore influence treatment's options. We aimed to examine whether the Biofire (R) FilmArray (R) has an effect on antibiotic treatment, duration of antibiotic therapy, and length of hospital stay within a pediatric cohort.Methods We included children who were admitted to inpatient treatment with an acute respiratory tract infection from 02/2017 to 04/2018 using the FA respiratory panel for pathogen detection. The study group data were compared to the retrospective data of children admitted from 02/2016 to 02/2017, using a proprietary multiplex RT-PCR.Results A total of 322 children of the study group and 464 children of the control group were analyzed for clinical symptoms, laboratory findings, antibiotic treatment, and length of hospital stay. There was no significant reduction (P < .05) of antibiotic treatment and length of hospital stay. CRP, prehospital antibiotic treatment, antibiotic treatment, past medical history, age, and further pathogen detection showed a significant impact on antibiotic therapy, duration of antibiotic treatment, and length of hospital stay.Conclusion The use of the FA did not result in a significant reduction of antibiotic treatment or in length of hospital stay. Other parameters had a more significant impact. Therefore, we suggest that standard operation procedures with therapy guidelines are necessary to provide an effective application of POCT systems.