在儿科重症监护室使用快速分子诊断肺炎小组支持临床决策:土耳其的单一中心经验
Gurkan Bozan1, Yalcin Kara2, Eylem Kiral1
1Pediatric Intensive Care Unit, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir 26040, Türkiye.
Microorganisms
|October 28, 2023
概括
儿童肺炎的快速分子检测显著有助于抗生素管理. 这种诊断面板提供及时的结果,使儿童重症监护病房患有下呼吸道感染的患者能够进行有效的治疗调整.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病 传染病 传染病
- 分子诊断学 分子诊断学
背景情况:
- 下呼吸道感染 (LRTI) 是全球儿童发病率和死亡率的主要原因之一.
- 及时的微生物学诊断对于儿童肺炎的向抗生素治疗至关重要.
- 评估快速诊断工具对于改善儿科重症监护室 (PICU) 患者的治疗结果至关重要.
研究的目的:
- 评估快速分子诊断肺炎小组 (FA-PP) 在患有LRTI的儿童中的实用性.
- 确定FA-PP结果对PICU设置中的抗生素治疗策略的影响.
- 通过分子测试来评估常见病原体和耐药性概况的识别.
主要方法:
- 从2019年至2023年间,对46名被诊断患有LRTI的儿童进行了71项结果的回顾性审查.
- 使用BioFire®,FilmArray肺炎面板加 (FA-PP) 进行快速分子检测.
- 分析了病原体的识别,潜在的疾病,机械通风的使用,以及与呼吸机相关的肺炎 (VAP) 病例.
主要成果:
- 在57例病例中,FA-PP检测到至少一种细菌病原体; 77%的儿童有潜在的疾病.
- 通常识别的病原体包括*Pseudomonas aeruginosa*,*Acinetobacter calcoaceticus baumannii复合体*,以及*Klebsiella pneumoniae*.这些病原体都被发现.
- 在60.6%的病例中,FA-PP结果引导了抗生素治疗调整 (54.5%升级,6.1%降低).
结论:
- 该FA-PP提供比传统方法更快的结果,促进快速的临床决策.
- 分子测试确定了耐药性概况,使优化抗生素治疗策略 (升级/降级) 成为可能.
- 这项研究强调了分子诊断在治疗儿科肺炎和PICU中VAP的价值.
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