Étude prospective de l’écologie virale hivernale dans un service de réanimation pédiatrique

Mortamet, Guillaume; Morello, R.; Jokic, M.; Vabret, Astrid; Leroux, M.; Brouard, J.; Dina, Julia

doi:10.1016/j.arcped.2014.10.025

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The pathogens identified in our PICU were similar to those in previous studies in the PICUs (9-11) and general ward (1). Additionally, a high pathogen identification rate of 61% in our study using mPCR testing is similar to that reported previously (64-82%) in other studies (11,12).…”

Section: Use Of Antibiotics and Broad-spectrum Antibiotics And The Le...supporting

confidence: 92%

Application of Multiplex Polymerase Chain Reaction for Pathogen Identification and Antibiotic Use in Children With Respiratory Infections in a PICU

Yoshida

Hatachi

Okamoto

et al. 2021

Pediatric Critical Care Medicine

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OBJECTIVES: To compare the pathogen identification rate and use of antibiotics before and after the implementation of multiplex polymerase chain reaction testing in children with respiratory infections in a PICU. DESIGN: Single-center, pre-post study. SETTING: PICU of Osaka Women’s and Children’s Hospital, Osaka, Japan. PATIENTS: Consecutive children with respiratory infections who were admitted to the PICU between December 2017 and November 2018 (premultiplex polymerase chain reaction period) and between March 2019 and February 2020 (postmultiplex polymerase chain reaction period). INTERVENTIONS: Conventional rapid antigen tests and bacterial culture tests were performed throughout the study period. Multiplex polymerase chain reaction testing using the FilmArray respiratory panel (BioFire Diagnostics, Salt Lake City, UT) was conducted to detect 17 viruses and three bacterial pathogens. During the postmultiplex polymerase chain reaction period, we did not recommend prescribing antibiotics for stable children, depending on the virus species and laboratory test results. MEASUREMENTS AND MAIN RESULTS: Ninety-six and 85 children were enrolled during the pre- and postmultiplex polymerase chain reaction periods, respectively. Rapid antigen tests identified pathogens in 22% of the children (n = 21) during the premultiplex polymerase chain reaction period, whereas rapid antigen tests and/or multiplex polymerase chain reaction testing identified pathogens in 67% of the children (n = 57) during the postmultiplex polymerase chain reaction period (p < 0.001). The most commonly identified pathogen using multiplex polymerase chain reaction testing was human rhino/enterovirus. Bacterial pathogens were identified in 50% of the children (n = 48) and 60% of the children (n = 51) during the pre- and postmultiplex polymerase chain reaction periods (p = 0.18). There were no differences in antibiotic use (84% vs 75%; p = 0.14), broad-spectrum antibiotic use (33% vs 34%; p = 0.91), or the duration of antibiotic use within 14 days of admission (6.0 vs 7.0 d; p = 0.45) between the pre- and postmultiplex polymerase chain reaction periods. CONCLUSIONS: Although the pathogen identification rate, especially for viral pathogens, increased using multiplex polymerase chain reaction testing, antibiotic use did not reduce in children with respiratory infections in the PICU. Definitive identification of bacterial pathogens and implementation of evidence-based antimicrobial stewardship programs employing multiplex polymerase chain reaction testing are warranted.

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Section: Use Of Antibiotics and Broad-spectrum Antibiotics And The Le...supporting

confidence: 92%

Application of Multiplex Polymerase Chain Reaction for Pathogen Identification and Antibiotic Use in Children With Respiratory Infections in a PICU

Yoshida

Hatachi

Okamoto

et al. 2021

Pediatric Critical Care Medicine

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“…In children, bronchiolitis and pneumonia are the most common causes of LRTI and are induced by a large and heterogeneous group of infectious agents, including bacteria, virus, and other aetiologies. Viral infections are the main causes, dominated by HRV and RSV [14][15][16][17][18], but bacterial co-infections are not rare [18,19]. The microbiological diagnosis of these infections, especially the proof of bacterial infection, is difficult to obtain.…”

Section: Introductionmentioning

confidence: 99%

Viral Identification Using Multiplex Polymerase Chain Reaction Testing Does Not Reduce Antibiotic Prescribing in Paediatric Intensive Care Units

et al. 2023

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PCR tests for viral identification, performed on nasopharyngeal secretions, have experienced a major boom in the last few years. Their use is very frequent, but their indications are still not well defined, especially in Paediatric Intensive Care Units (PICU). These tests are used for the microbiological diagnosis of lower respiratory infections but can be used in other situations. The aim of the study was to investigate the effect of viral identification on antibiotic therapy management. We conducted a single-centre retrospective study from 1 October 2017 to 31 December 2019. This study included all consecutive FilmArray® Respiratory Panel tests performed in patients hospitalised in a PICU. Patients were identified using the microbiology laboratory prospective database and data were extracted from the medical record. 544 tests corresponding to 408 patients were included. The main reasons for testing were pneumonia (34%) and bronchiolitis (24%). In 70% of cases, at least one virus was identified, with Human Rhinovirus (56%) and Respiratory Syncytial Virus (28%) being the two predominant. Bacterial co-infection was present in 25% of cases. Viral identification was not associated with reduced antibiotic therapy. On multivariate analysis, antibiotic management was significantly associated with clinical gravity, CRP value or radiology findings regardless of virus identification. Viral identification has an epidemiological value, but antibiotic prescription relies on other factors.

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Diagnosis of Sepsis with Cell-free DNA by Next-Generation Sequencing Technology in ICU Patients

Long

Zhang

Gong

et al. 2016

Archives of Medical Research

178

130

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Étude prospective de l’écologie virale hivernale dans un service de réanimation pédiatrique

Cited by 3 publications

References 17 publications

Application of Multiplex Polymerase Chain Reaction for Pathogen Identification and Antibiotic Use in Children With Respiratory Infections in a PICU

Application of Multiplex Polymerase Chain Reaction for Pathogen Identification and Antibiotic Use in Children With Respiratory Infections in a PICU

Viral Identification Using Multiplex Polymerase Chain Reaction Testing Does Not Reduce Antibiotic Prescribing in Paediatric Intensive Care Units

Diagnosis of Sepsis with Cell-free DNA by Next-Generation Sequencing Technology in ICU Patients

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