Clinical Impact of RT-PCR for Pediatric Acute Respiratory Infections: A Controlled Clinical Trial

Wishaupt, Jérôme O.; Russcher, Anne; Smeets, Leo C.; Versteegh, F. G. A.; Hartwig, Nico G.

doi:10.1542/peds.2010-2779

Cited by 108 publications

(121 citation statements)

References 24 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…[15][16][17][18][19] In pleural empyema, RT-PCR played an important role identifying pathogens in those patients with no culture growth, who had followed a previous antibiotic course. 15,16 Similar results were available for microbiological diagnosis in spontaneous bacterial peritonitis where RT-PCR increased the efficacy of cultures: RT-PCR detected pathogen in nearly all the patients with positive culture, and RT-PCR resulted positive in half of the patients with negative cultures.…”

Section: Articlementioning

confidence: 99%

“…14 RT-PCR has been employed in several studies with pediatric populations confirming that a prompt detection of either viral or bacterial agent contributes to patient care, which in turn has effect on both hospital stay and antibiotic usage. [15][16][17][18][19] To date, a couple of studies about the use of RT-PCR to detect pathogens in the peritoneal fluid during acute appendicitis have been carried out without any further conclusion. 20,21 Taking into account these previous reports, we set a pilot study in order to better understand and compare the potential advantages of DNA amplification versus traditional bacterial growth culture in complicated acute appendicitis, and identify, when possible, those categories of patients, who might benefit from this combined approach.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

et al. 2016

View full text Add to dashboard Cite

Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases), Pseudomonas aeruginosa (3), Fusobacterium necrophorum (3), Adenovirus (2), E.coli (1), Klebsiella pneumoniae (1), Serratia marcescens/Enterobacter cloacae (1). Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.

show abstract

Section: Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In the ICU setting however, viral detection would not tend to alter antibiotic use due to concerns of secondary bacterial infection. 244,255 On the other hand, rapidly detecting a bacterial pathogen may aid a clinician's decision to prescribe and/or continue particular antibiotics earlier, in both settings. 255 The fast turn-around of PCR results compared to culture, may have also contributed to a reduction in healthcare costs.…”

Section: Resultsmentioning

confidence: 99%

“…244,255 On the other hand, rapidly detecting a bacterial pathogen may aid a clinician's decision to prescribe and/or continue particular antibiotics earlier, in both settings. 255 The fast turn-around of PCR results compared to culture, may have also contributed to a reduction in healthcare costs. Where a diagnosis is quickly obtained, additional (often unnecessary) laboratory tests and/or diagnostic imaging may be avoided.…”

Section: Resultsmentioning

confidence: 99%

“…[286][287][288] Where B. pertussis was identified as the pathogen, appropriate antibiotics could be prescribed, which have the most benefit when commenced early during the course of illness. 289 In the hospital and ICU settings, although viral detection may not alter antibiotic use due to concerns of secondary bacterial infection, 244,255,290 rapidly detecting a bacterial pathogen such as B. pertussis would aid a clinician's decision to prescribe and/or continue particular antibiotics. 255 In hospital settings, rapid diagnosis of pertussis or another infectious respiratory pathogen would also accelerate the implementation of appropriate infection control measures, limiting the likelihood of nosocomial infections.…”

Section: Clinicalmentioning

confidence: 99%

See 1 more Smart Citation

The diagnosis and epidemiology of pertussis in Australia

Kaczmarek¹

View full text Add to dashboard Cite

Pertussis, more commonly known as whooping cough, is one of the most common vaccine-preventable infections reported in Australia. In the last decade, pertussis incidence has increased in Australia and overseas, with large sustained epidemics occurring most notably in developed countries. Australia had a pertussis epidemic between 2009 and 2012, which peaked during 2011 with 38,602 notified cases. The role of improved diagnostic methods, particularly the use of polymerase chain reaction (PCR) testing, has been hypothesised to have led to improved case ascertainment and superior detection of disease activity. This Thesis is comprised of five distinct studies contributing to the investigation of this hypothesis.In Australia, the incidence of pertussis is predominantly monitored using notification data, with the case definition for notifications heavily reliant on laboratory confirmation. By analysing pertussis notifications between 1991 and 2013 by diagnostic test method, I was able to demonstrate that PCR quickly replaced all other laboratory methods for pertussis diagnosis from 2005 onwards, with the exception of persisting serology use in a proportion of adolescents and adults. In addition, a change in the age distribution of notifications was observed over time, with increasing pertussis incidence among older children and adolescents.As notification data can be biased by changes in testing practices, awareness, and definitions, my next study investigated pertussis testing trends in the general practice (GP, primary care) setting between 2000 and 2011 using data from the Bettering the Evaluation And Care of Health (BEACH) program. Among a stable set of GP encounters for respiratory illness, it was observed that the likelihood of individuals being tested for pertussis in 2010-2011 was seven times higher compared to ten years earlier. These findings, at least in part, suggest that notifications have been amplified due to increased testing.To gather more information about the contribution of increased testing to the pertussis epidemic, the incidence of severe pertussis cases admitted to intensive care units (ICUs) was reviewed, as the ICU setting is less likely to be biased by changes in diagnostic This Thesis makes an important and original contribution to understanding the recent resurgence of pertussis in Australia and overseas by addressing gaps in knowledge about changes in diagnostic testing. Although a true increase in pertussis incidence occurred in Australia, increasing PCR diagnosis allowed better case detection across all age groups and healthcare settings. Greater understanding of pertussis epidemiology as a result of PCR diagnosis should ultimately improve pertussis immunisation and control programs, through better identification of at-risk groups.iv

show abstract

Effect of Rapid Respiratory Virus Testing on Antibiotic Prescribing Among Children Presenting to the Emergency Department With Acute Respiratory Illness

et al. 2021

View full text Add to dashboard Cite

show abstract

Clinical Impact of RT-PCR for Pediatric Acute Respiratory Infections: A Controlled Clinical Trial

Abstract: RT-PCR testing has a high yield of viral diagnoses, but rapid communication does not lead to decreases in hospital admissions, shorter hospital stays, or less antibiotic use for children with acute respiratory infections.

Cited by 108 publications

References 24 publications

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

The diagnosis and epidemiology of pertussis in Australia

Effect of Rapid Respiratory Virus Testing on Antibiotic Prescribing Among Children Presenting to the Emergency Department With Acute Respiratory Illness

Contact Info

Product

Resources

About