Rapid Molecular Tests for Detecting Respiratory Pathogens Reduced the Use of Antibiotics in Children

Abstract

Multiplex polymerase chain reaction (mPCR) is increasingly being used to diagnose infections caused by respiratory pathogens in pediatric inpatient facilities. mPCR assays detect a broader array of viruses, with higher specificity and sensitivity and faster turnaround than previous assays. We adapted the FilmArray Respiratory Panel (FA-RP) for diagnosing respiratory infections. FA-RP is an in vitro mPCR assay that simultaneously and rapidly (in about 1 h) detects 20 pathogens directly from respiratory specimens. Here, we studied the clinical efficacy of FA-RP in children who underwent testing for respiratory pathogens at Yeungnam University Hospital from November 2015 to August 2018. From November 2015 to June 2016, routine mPCR testing was performed on nasopharyngeal swabs using the routine mPCR kit. From November 2016 to July 2018, mPCR testing was performed using FA-RP. A total of 321 tests by routine mPCR and 594 tests by FA-RP were included. The positive detection rates for routine mPCR and FA-RP were 71.3% and 83.3%, respectively. FA-RP reduced the lead time, waiting time, turnaround time, intravenous (IV) antibiotic use, and length of hospital stay for pediatric patients. The decreased use of antibiotics is expected to reduce antibiotic resistance in children.

Epidemiology of Respiratory Pathogens in Children with Severe Acute Respiratory Infection and Impact of the Multiplex PCR Film Array Respiratory Panel: A 2-Year Study

“…ese results are comparable to those reported by several studies [19,24]. It was noticeable that HRV was the most detected respiratory pathogen in studies conducted in our country and other ones [1,4,9,18,19,20,24,29]. Lei et al [20] have noted in their study that HRV was responsible for both upper and lower respiratory infections.…”

“…In Morocco, there has been a significant reduction in the infant mortality rate over the past decades, due to the progress in strengthening vaccination programmes and control of infectious diseases, including acute respiratory infections [7,8]. Furthermore, understanding the epidemiology and aetiology of acute respiratory infections in hospitalised children is essential for the development of a strategy for the rapid and optimal management of these infections, as well as the implementation of means to prevent and control them [9].…”

“…Despite this, respiratory infections are a major cause of antibiotic overuse [11]. Antibiotics are not only ineffective but also expose children to adverse effects and contribute to the emergence and spread of multidrug-resistant bacteria and increased economic costs associated with infections [9]. e use of molecular methods, especially real-time multiplex polymerase chain reaction (mPCR), has considerably improved the detection of respiratory pathogens [12].…”

“…e mPCR allowed to detect a wide range of respiratory viruses and their subtype as well as some atypical bacteria with high sensitivity and specificity [13,14]. e molecular diagnosis using a syndromic approach for the detection of respiratory pathogens is being used significantly more in paediatric hospitals and allows a rapid distinction between viral and bacterial infections especially by the FilmArray ® Respiratory Panel (FA-RP) [9]. It facilitates the management of patients with SARI and guides the clinical decision.…”

“…It facilitates the management of patients with SARI and guides the clinical decision. Moreover, it helps to limit their spread, reduces antibiotics overuse, and guides the development of new vaccines [9,15].…”