The impact analysis of a multiplex PCR respiratory panel for hospitalized pediatric respiratory infections in Japan
The impact analysis of a multiplex PCR respiratory panel for hospitalized pediatric respiratory infections in Japan
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DOI：
10.1016/j.jiac.2019.07.014
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发表时间：
2020-01-01
影响因子：
2.2
通讯作者：
Yoshida, Sayaka
中科院分区：
文献类型：
--
作者：
Kitano, Taito;Nishikawa, Hiroki;Yoshida, Sayaka
背景：感染的快速分子诊断有助于及时治疗和抗菌药物管理。然而，每个国家或社区的效益和成本效益各不相同，因为它们有不同的标准做法和卫生保健系统。在日本，快速抗原检测(大鼠)经常用于儿科呼吸道感染。我们调查了日本一家社区医院使用多重聚合酶链式反应(MPCR)呼吸面板治疗儿科呼吸道感染的效果和成本效益。方法：我们于2018年3月26日在住院的儿科呼吸道感染患者中用mPCR呼吸面板(FilmArray(R))取代了大鼠。我们比较了大鼠时期(2018年3月至2019年4月)和大鼠时期(2012年3月至2018年3月)期间的抗菌治疗天数(DOT)和住院时间(LOS)。结果：在大鼠和mPCR期内，分别分析了1132例和149例患者。大鼠组和mPCR组的平均生存时间分别为12.82vs8.56d(p<；0.001)和8.18dvs6.83d(p=0.032)。入院总费用分别为258,824例(2331.7美元)和243,841例(2196.8美元)。病原体检测率分别为30.2%和87.2%(p<；0.001)。结论：与传统大鼠相比，mPCR检测有助于降低日本一家社区医院需要住院的儿童呼吸道感染的DOT和LOS。然而，适当的管理计划对于进一步减少不必要的抗菌药使用至关重要。(C)2019年日本化疗学会和日本传染病协会。爱思唯尔有限公司出版。保留所有权利。
Background: Rapid molecular diagnosis of infections has contributed to timely treatments and antimicrobial stewardship. However, the benefit and cost-effectiveness vary in each country or community because they have different standard practices and health care systems. In Japan, rapid antigen tests (RATs) have been frequently used for pediatric respiratory infections. We investigated the impact and cost-effectiveness of a multiplex PCR (mPCR) respiratory panel for pediatric respiratory infections in a Japanese community hospital.Methods: We replaced RATs with an mPCR respiratory panel (FilmArray (R)) for admitted pediatric respiratory infections on March 26, 2018. We compared the days of antimicrobial therapy (DOT) and length of stay (LOS) during the mPCR period (March 2018 to April 2019) with those of the RAT period (March 2012 to March 2018).Results: During the RAT and mPCR periods, 1132 and 149 patients were analyzed. The DOT/case was 12.82 vs 8.56 (p < 0.001), and the LOS was 8.18 vs 6.83 days (p = 0.032) in the RAT and mPCR groups, respectively. The total costs during admissions were \258,824 ($2331.7) and \243,841 ($2196.8)/case, respectively. Pathogen detection rates were 30.2% vs 87.2% (p < 0.001).Conclusion: Compared to conventional RATs, the mPCR test contributed to a reduction in the DOT and LOS in a Japanese community hospital for admission-requiring pediatric respiratory infections. However, a proper stewardship program is essential to further reduce the unnecessary usage of antimicrobials. (C) 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.