Repeat Tracheal Aspirate Cultures: A Port in the Storm or a Sinking Ship?*

Prinzi, Andrea; Chiotos, Kathleen

doi:10.1097/pcc.0000000000003276

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…These pre-analytic considerations are particularly important in special populations like pediatrics, where the primary respiratory specimen collected is ETA due to children's inability to produce sputum. Several studies have noted that repeat ETA specimens and specimens from patients with chronic tracheostomies rarely yield new information and may not be appropriate for mPCR or culture, highlighting the need for limiting unnecessary testing [70][71][72][73]. Respiratory testing is fundamental to the management of pneumonia, especially VAP, and these studies demonstrate opportunities for the use of diagnostic testing algorithms that may be extended to molecular testing and potentially support probabilistic decision-making in the pre-analytic period.…”

Section: Current State Of Diagnostic Stewardship and Future Directionsmentioning

confidence: 99%

Breaking Boundaries in Pneumonia Diagnostics: Transitioning from Tradition to Molecular Frontiers with Multiplex PCR

Walker,

Timbrook,

Hommel

et al. 2024

Diagnostics

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The advent of rapid molecular microbiology testing has revolutionized infectious disease diagnostics and is now impacting pneumonia diagnosis and management. Molecular platforms offer highly multiplexed assays for diverse viral and bacterial detection, alongside antimicrobial resistance markers, providing the potential to significantly shape patient care. Despite the superiority in sensitivity and speed, debates continue regarding the clinical role of multiplex molecular testing, notably in comparison to standard methods and distinguishing colonization from infection. Recent guidelines endorse molecular pneumonia panels for enhanced sensitivity and rapidity, but implementation requires addressing methodological differences and ensuring clinical relevance. Diagnostic stewardship should be leveraged to optimize pneumonia testing, emphasizing pre- and post-analytical strategies. Collaboration between clinical microbiologists and bedside providers is essential in developing implementation strategies to maximize the clinical utility of multiplex molecular diagnostics in pneumonia. This narrative review explores these multifaceted issues, examining the current evidence on the clinical performance of multiplex molecular assays in pneumonia, and reflects on lessons learned from previous microbiological advances. Additionally, given the complexity of pneumonia and the sensitivity of molecular diagnostics, diagnostic stewardship is discussed within the context of current literature, including implementation strategies that consider pre-analytical and post-analytical modifications to optimize the clinical utility of advanced technologies like multiplex PCR.

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Section: Current State Of Diagnostic Stewardship and Future Directionsmentioning

confidence: 99%