Direct-from-Specimen Pathogen Identification

Couturier, Marc Roger; Bard, Jennifer Dien

doi:10.1016/j.cll.2019.05.005

Cited by 10 publications

(15 citation statements)

References 27 publications

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“…Syndromic Panels "Syndromic panel" is a term commonly used in clinical microbiology when referring to rapid, multiplexed amplification and detection platforms that received US FDA approval or clearance for a set list of targets in a specific sample type [6]. This includes panels for gastrointestinal, central nervous system and respiratory tract infection-associated potential pathogens.…”

Section: Rapid Molecular Testingmentioning

confidence: 99%

“…For a detailed review of individual respiratory tract rapid syndromic respiratory panels, readers are referred to the following references (6,8). While individual targets vary, in general, these panels contain most known, widely circulating respiratory viruses and a limited set of atypical upper respiratory tract bacterial targets.…”

Section: Respiratory Tract Infection Syndromic Panelsmentioning

confidence: 99%

“…Two panels have recently been cleared by the US FDA for sputum, endotracheal aspirate and bronchoalveolar lavage specimens. One of these panels includes the same viral targets as their upper respiratory tract panel, while both have the same 18 bacterial targets and 8 to 10 antibiotic resistance genes [6]. This expansive number of bacterial targets may lead to tremendous confusion for the ordering physician if many targets are positive on the same sample, including antibiotic resistance genes that can be attributed to multiple species.…”

Section: Respiratory Tract Infection Syndromic Panelsmentioning

confidence: 99%

“…As with respiratory panels, there are a number of US FDAapproved rapid syndromic panels for gastroenteritis reviewed in the following references (6,8). While these tests have improved sensitivity and reduced time to result over bacterial culture for common agents of community-acquired diarrhea, they introduce new issues.…”

Section: Gastrointestinal Tract Infection Syndromic Panelsmentioning

confidence: 99%

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Appropriate Use and Future Directions of Molecular Diagnostic Testing

Graf

Pancholi

2020

Curr Infect Dis Rep

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Purpose of Review Major technologic advances in two main areas of molecular infectious disease diagnostics have resulted in accelerated adoption or ordering, outpacing implementation, and clinical utility studies. Physicians must understand the limitations to and appropriate utilization of these technologies in order to provide cost-effective and well-informed care for their patients. Recent Findings Rapid molecular testing and, to a lesser degree, clinical metagenomics are now being routinely used in clinical practice. While these tests allow for a breadth of interrogation not possible with conventional microbiology, they pose new challenges for diagnostic and antimicrobial stewardship programs. This review will summarize the most recent literature on these two categories of technologic advances and discuss the few studies that have looked at utilization and stewardship approaches. This review also highlights the future directions for both of these technologies. Summary The appropriate utilization of rapid molecular testing and clinical metagenomics has not been well established. More studies are needed to assess their prospective impacts on patient management and antimicrobial stewardship efforts as the future state of infectious disease diagnostics will see continued expansion of these technologic advances.

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Section: Rapid Molecular Testingmentioning

confidence: 99%

Section: Respiratory Tract Infection Syndromic Panelsmentioning

confidence: 99%

Section: Respiratory Tract Infection Syndromic Panelsmentioning

confidence: 99%

Section: Gastrointestinal Tract Infection Syndromic Panelsmentioning

confidence: 99%

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Appropriate Use and Future Directions of Molecular Diagnostic Testing

Graf

Pancholi

2020

Curr Infect Dis Rep

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“…So how are upper respiratory syndromic panels affecting patient care? Results are mixed, with some studies showing a decrease in antibiotic therapy, decreased length of hospital stay, or decreased additional tests and imaging studies, 32 whereas other studies showed no benefit. 33 Many of the studies found benefits only for patients with positive influenza results, 34 , 35 showing that limited testing may be sufficient for most patients.…”

Section: Detection Of Upper Respiratory Infectionmentioning

confidence: 99%

Panels and Syndromic Testing in Clinical Microbiology

Bard

McElvania

2020

Clinics in Laboratory Medicine

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Syndromic panels have allowed clinical microbiology laboratories to rapidly identify bacteria, viruses, fungi, and parasites and are now fully integrated into the standard testing practices of many clinical laboratories. To maximize the benefit of syndromic testing, laboratories must implement strict measures to ensure that syndromic panels are being used responsibly. This article discusses commercially available syndromic panels, the benefits and limitations of testing, and how diagnostic and laboratory stewardship can be used to optimize testing and improve patient care while keeping costs at a minimum.

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Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions

Rader

Stevens

Bearman

2021

Curr Infect Dis Rep

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Purpose of Review Syndromic multiplex polymerase chain reaction (mPCR) panels offer the antimicrobial steward a rapid tool for optimizing and de-escalating antimicrobials. In this review, we analyze the role of syndromic mPCR in respiratory, gastrointestinal, and central nervous system infections within the context of antimicrobial stewardship efforts. Recent Findings For all mPCR syndromic panels, multiple studies analyzed the pre-and-post implementation impact of mPCR on antimicrobial utilization. Prospective studies and trials of respiratory mPCR stewardship interventions, including diagnostic algorithms, educational efforts, co-testing with procalcitonin, and targeted provider feedback currently exist. For gastrointestinal and cerebrospinal fluid mPCR, fewer peer-reviewed reports exist for the use of mPCR in antimicrobial stewardship. These studies demonstrated an inconsistent trend towards decreasing antibiotic use with mPCR. This is further limited by a lack of statistical significance, the absence of controlled, prospective trials, and issues with data generalizability. Summary Antibiotic overuse may improve when mPCR is coupled with electronic medical record algorithm-based approaches and direct provider feedback by an antimicrobial stewardship professional. mPCR may prove a useful tool for antimicrobial stewardship but future studies are needed to define the best practice for its utilization.

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Direct-from-Specimen Pathogen Identification

Cited by 10 publications

References 27 publications

Appropriate Use and Future Directions of Molecular Diagnostic Testing

Appropriate Use and Future Directions of Molecular Diagnostic Testing

Panels and Syndromic Testing in Clinical Microbiology

Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions

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