Frühe Optimierung der Antibiotikatherapie durch den schnellen Nachweis von Erregern und Empfindlichkeit

Wilke, Michael; Worf, Kerstin; Heinlein, Wolfgang; Kast, Tilman; Bodmann, Klaus-Friedrich

doi:10.1007/s00063-020-00680-5

Cited by 2 publications

(2 citation statements)

References 56 publications

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“…An inappropriate antibiotic therapy is associated with a fivefold reduction of survival in septic shock [ 32 ]. From an economic standpoint, earlier adequate therapy can reduce LOS and cost [ 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

Next-generation microbiological testing in intraabdominal infections with PCR technology

Horn,

Höhn,

Strotmann

et al. 2024

Langenbecks Arch Surg

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Purpose Intraabdominal infections (IAI) are increasing worldwide and are a major contributor to morbidity and mortality. Among IAI, the number of multi-drug resistant organisms (MDRO) is increasing globally. We tested the Unyvero A50® for intraabdominal infections, compared the detected microorganisms and antibiotic resistance, and compared the results with those of routine microbiology. Methods We prospectively compared samples obtained from surgical patients using PCR-based Unyvero IAI cartridges against routine microbiology for the detection of microorganisms. Additionally, we identified clinical parameters that correlated with the microbiological findings. Data were analyzed using the t-test and Mann–Whitney U test. Results Sixty-two samples were analyzed. The PCR system identified more microorganisms, mostly Bacteroides species, Escherichia coli, and Enterococcus spp. For bacterial resistance, the PCR system results were fully concordant with those of routine microbiology, resulting in a sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of 100%. The sensitivity, specificity, PPV, and NPV for the detection of microorganisms were 74%, 58%, 60%, and 72%, respectively. CRP levels were significantly higher in patients with detectable microorganisms. We identified more microorganisms and bacterial resistance in hospital-acquired intra-abdominal infections by using the PCR system. Discussion IAI warrants early identification of the microorganisms involved and their resistance to allow for adequate antibiotic therapy. PCR systems enable physicians to rapidly adjust their antibiotic treatment. Conventional microbiological culture and testing remain essential for determining the minimal growth inhibition concentrations for antibiotic therapy.

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Section: Discussionmentioning

confidence: 99%

Next-generation microbiological testing in intraabdominal infections with PCR technology

Horn,

Höhn,

Strotmann

et al. 2024

Langenbecks Arch Surg

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“…The misuse and overuse of antibiotics are harmful to both society and individual patients: for society, the overuse and misuse of antibiotics may lead to an increased global epidemic of antibiotic resistance [ 66 ]; for patients, it may lead to adverse effects such as acute kidney injury and C. difficile infection [ 67 ]. Studies have shown that step-down therapy for septic shock is a safe strategy with low mortality, and the implementation of this strategy is fully justified [ 68 ], in addition to the economic advantages of optimizing antibiotic therapy through antibiotic step-down [ 69 ]. Therefore, early downgrading should be emphasized when using combination therapy in septic shock or neutropenia in HLH.…”

Section: Treatment Of Complex Infection In Hlhmentioning

confidence: 99%

Management of Complex Infections in Hemophagocytic Lymphohistiocytosis in Adults

Zhang

Cheng

et al. 2023

Microorganisms

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Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive immune system activation and inflammatory response due to a variety of primary and secondary factors that can cause a range of clinical symptoms and, in severe cases, life-threatening conditions. Patients with HLH are at increased risk of infection due to their abnormal immune function as well as chemotherapy and immunosuppressive therapy at the time of treatment. At the same time, the lack of specific clinical features makes complex infections in HLH challenging to diagnose and treat. The management of complex infections in HLH requires a multidisciplinary and integrated approach including the early identification of pathogens, the development of anti-infection protocols and regimens, and the elimination of potential infection factors. Especially in HLH patients with septic shock, empirical combination therapy against the most likely pathogens should be initiated, and appropriate anti-infective regimens should be determined based on immune status, site of infection, pathogens, and their drug resistance, with timely antibiotic adjustment by monitoring procalcitonin. In addition, anti-infection prophylaxis for HLH patients is needed to reduce the risk of infection such as prophylactic antibiotics and vaccinations. In conclusion, complex infection in HLH is a serious and challenging disease that requires vigilance, early identification, and timely anti-infective therapy.

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Frühe Optimierung der Antibiotikatherapie durch den schnellen Nachweis von Erregern und Empfindlichkeit

Cited by 2 publications

References 56 publications

Next-generation microbiological testing in intraabdominal infections with PCR technology

Next-generation microbiological testing in intraabdominal infections with PCR technology

Management of Complex Infections in Hemophagocytic Lymphohistiocytosis in Adults

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