Impact of the multiplex molecular FilmArray Respiratory Panel on antibiotic prescription and clinical management of immunocompromised adults with suspected acute respiratory tract infections: A retrospective before–after study

Bergese, Silvina; Fox, Barbara J.; García-Allende, Natalia; Elisiri, María Elisa; Schneider, Ana E.; Ruiz, Juan; Gonzalez-Fraga, Sol; Rodríguez, Viviana; Fernandez-Canigia, Liliana

doi:10.1016/j.ram.2023.03.001

Cited by 1 publication

(1 citation statement)

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“…Different authors [8,13,[29][30][31] have reported that multiplex bacterial PCR testing of quality respiratory samples decreases the duration of inadequate antibiotic treatment of patients admitted to the hospital with pneumonia and risk of Gram-negative bacilli infection. However, most of these studies have been performed in general hospitalization patients [8,29,31], or in haematologic [30] or paediatric patient groups [13] and little information exists on the impact of these techniques in critically ill adult patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Microbiological Impact of Implementing a Decision Support Algorithm through Microbiologic Rapid Diagnosis in Critically Ill Patients: An Epidemiological Retrospective Pre-/Post-Intervention Study

Rodríguez,

Gómez,

Sarvisé

et al. 2023

Biomedicines

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Background: Data on the benefits of rapid microbiological testing on antimicrobial consumption (AC) and antimicrobial resistance patterns (ARPs) are scarce. We evaluated the impact of a protocol based on rapid techniques on AC and ARP in intensive care (ICU) patients. Methods: A retrospective pre- (2018) and post-intervention (2019–2021) study was conducted in ICU patients. A rapid diagnostic algorithm was applied starting in 2019 in patients with a lower respiratory tract infection. The incidence of nosocomial infections, ARPs, and AC as DDDs (defined daily doses) were monitored. Results: A total of 3635 patients were included: 987 in the pre-intervention group and 2648 in the post-intervention group. The median age was 60 years, the sample was 64% male, and the average APACHE II and SOFA scores were 19 points and 3 points. The overall ICU mortality was 17.2% without any differences between the groups. An increase in the number of infections was observed in the post-intervention group (44.5% vs. 17.9%, p < 0.01), especially due to an increase in the incidence of ventilator-associated pneumonia (44.6% vs. 25%, p < 0.001). AC decreased from 128.7 DDD in 2018 to 66.0 DDD in 2021 (rate ratio = 0.51). An increase in Pseudomonas aeruginosa susceptibility of 23% for Piperacillin/tazobactam and 31% for Meropenem was observed. Conclusion: The implementation of an algorithm based on rapid microbiological diagnostic techniques allowed for a significant reduction in AC and ARPs without affecting the prognosis of critically ill patients.

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