Rapid diagnostic tests in the management of pneumonia

Riccobono, Eleonora; Bussini, Linda; Giannella, Maddalena; Viale, Pierluigi; Rossolini, Gian María

doi:10.1080/14737159.2022.2018302

Cited by 7 publications

(4 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The introduction of fast molecular microbiology tests has overturned the concepts of empirical therapy/targeted therapy. Moreover, an ongoing trend to avoid excessive and possibly unnecessary durations of antibiotic therapies can be observed [46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis

et al. 2023

View full text Add to dashboard Cite

Background: Trauma is a leading cause of death and disability. Patients with trauma undergoing invasive mechanical ventilation (IMV) are at risk for ventilator-associated events (VAEs) potentially associated with a longer duration of IMV and increased stay in the intensive care unit (ICU). Methods: We conducted a retrospective cohort study aimed to evaluate the incidence of infection-related ventilator-associated complications (IVACs), possible ventilator-associated pneumonia (PVAP), and their characteristics among patients experiencing severe trauma that required ICU admission and IMV for at least four days. We also determined pathogens implicated in PVAP episodes and characterized the use of antimicrobial therapy. Results: In total, 88 adult patients were included in the main analysis. In this study, we observed that 29.5% of patients developed a respiratory infection during ICU stay. Among them, five patients (19.2%) suffered from respiratory infections due to multi-drug resistant bacteria. Patients who developed IVAC/PVAP presented lower total GCS (median value, 7; (IQR, 9) vs. 12.5, (IQR, 8); p = 0.068) than those who did not develop IVAC/PVAP. Conclusions: We observed that less than one-third of trauma patients fulfilling criteria for ventilator associated events developed a respiratory infection during the ICU stay.

show abstract

Section: Discussionmentioning

confidence: 99%

Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…These characteristics may become crucial to optimize the use of novel agents active against GNB-DTR in the case of severe infections, by conspicuously reducing the time window of empirical therapy. Consequently, rapid tests could be very useful for both rapid de-escalation and rapid escalation, with potential favorable impacts on patients’ outcomes [18 ▪ ,22]. Nonetheless, their use should be tailored to the local microbiological epidemiology and requires both laboratory personnel availability and clinicians’ expertise in the interpretation of results to guide treatment decisions.…”

Section: The Role Of Rapid Diagnostic Tests In the Early Approach To ...mentioning

confidence: 99%

“…Furthermore, the increased availability of either phenotypical or molecular rapid diagnostic tests in real-life scenarios is an additional, potential game changer. Indeed, if properly used, rapid tests could considerably reduce the duration of inappropriate empirical therapy [12–17,18 ▪ ,19–23].…”

Section: Introductionmentioning

confidence: 99%

Empirical antibiotic therapy for difficult-to-treat Gram-negative infections: when, how, and how long?

Bassetti

Vena

Labate

et al. 2022

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of reviewTo discuss empirical therapy for severe infections due to Gram-negative bacteria with difficult-to-treat resistance (GNB-DTR) in current clinical practice, focusing in particular on the positioning of novel therapeutic agents and rapid diagnostic tests. Recent findingsThe current era of novel agents active against GNB-DTR and showing differential activity against specific determinants of resistance is an unprecedented scenario, in which the clinical reasoning leading to the choice of the empirical therapy for treating severe GNB-DTR infections is becoming more complex, but it also allows for enhanced treatment precision. SummaryNovel agents should be used in line with antimicrobial stewardship principles, aimed at reducing selective pressure for antimicrobial resistance. However, this does not mean that they should not be used. Indeed, excesses in restrictive uses may be unethical by precluding access to the most effective and less toxic treatments for patients with severe GNB-DTR infections. Given these premises (the 'how'), empirical treatment with novel agents should be considered in all patients with risk factors for GNB-DTR and severe clinical presentation of acute infection (the 'when'). Furthermore, empirical novel agents should preferably be continued only for a few hours, until de-escalation, modification, or confirmation (as targeted therapy) is made possible by the results of rapid diagnostic tests (the 'how long').

show abstract

“…Currently, conventional methods (CMs) for detecting pathogens responsible for pulmonary infections mainly include smear microscopy, microbial culture, immunological tests, and polymerase chain reaction [5]. However, these methods have some disadvantages, such as low sensitivity, high false-positive rates, long culture cycles, and narrow detection ranges, which do not meet the standards of precision medicine.…”

mentioning

confidence: 99%

Application of targeted next-generation sequencing to identify pathogens in the bronchoalveolar lavage fluid of adults with pulmonary infections

He,

Wu,

Liang

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Targeted next-generation sequencing (tNGS) has emerged as an efficient diagnostic method for pathogens identification. herein, we aimed to evaluate its performance in pathogen detection in bronchoalveolar lavage fluid (BALF). Methods BALF samples were obtained from 262 adult patients with pulmonary infection and were detected by tNGS, microbial culture, Xpert® MTB/RIF assay, and Aspergillus galactomannan (GM) test. Results In total, 47 potential pathogens were identified in the BALF samples by tNGS, including 21 bacteria, 13 viruses, 11 fungi, 1 parasite, and 1 mycoplasma. The bacterial detection rates of tNGS and ordinary bacterial culture were 74.0% (194/262) and 28.2% (74/262), respectively. The rates of negative, positive, and total consistent and the kappa value between tNGS and bacterial culture were 30.8%, 86.4%, 46.4%, and 0.116, respectively. The positive rate of fungal identification by tNGS was slightly higher than that of fungal culture (31.7% (83/262) and 22.9% (60/262), respectively). The rates of positive, negative, and total consistent and the kappa value between tNGS and fungal culture were 68.9%, 79.1%, 76.7%, and 0.424, respectively. Among the 42 patients with suspected tuberculosis infection, 23 patients showed positive results on both tNGS and Xpert® MTB/RIF assay. The rates of positive, negative, and total consistent and the kappa value between tNGS and pert® MTB/RIF assay were 100.0%, 68.4%, 85.7%, and 0.704, respectively. Finally, the sensitivity and specificity of tNGS versus the GM test were 57.1% and 90.6% versus 71.4% and 82.7%, respectively, when the fungal culture was used as the gold standard for detecting Aspergillus. Additionally, the sensitivity and specificity of tNGS increased to 86.2% and 98.7%, whereas the sensitivity of the GM test decreased to 69.0% when clinically diagnosed Aspergillus infection was used as a reference standard. The read counts of Aspergillus detected by tNGS and the optical density of the GM test were not significantly correlated. Conclusions tNGS is a promising method for detecting pathogens in BALF with a notably higher positive detection rate and a higher sensitivity and/or specificity compared with those of the conventional test.

show abstract

Rapid diagnostic tests in the management of pneumonia

Cited by 7 publications

References 85 publications

Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis

Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis

Empirical antibiotic therapy for difficult-to-treat Gram-negative infections: when, how, and how long?

Application of targeted next-generation sequencing to identify pathogens in the bronchoalveolar lavage fluid of adults with pulmonary infections

Contact Info

Product

Resources

About