聚合酶连锁反应用于早期识别导致肺炎的细菌在通风的手术和创伤患者
Aaron Pollock1, Justin Bailey, Hunter Parmer
1From the Department of Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, Tennessee.
The journal of trauma and acute care surgery
|February 27, 2025
概括
生物火膜阵列肺炎组 (BFPP) 准确地识别了疑似肺炎的通风患者中的细菌. 10^6 GCN/mL的BFPP切线是敏感和特异的,指导向的抗生素治疗,减少不必要的经验治疗.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 诊断微生物学 诊断微生物学
背景情况:
- 呼吸机相关性肺炎 (VAP) 影响了20-25%的直管创伤患者.
- 早期,有效的抗生素治疗对于减少VAP发病率和死亡率至关重要.
研究的目的:
- 评估Biofire FilmArray肺炎小组 (BFPP) 的敏感性和特异性,用于预测细菌病原体.
- 评估BFPP在直管患者的支气管支气管洗 (BAL) 当天指导抗生素治疗中的实用性.
主要方法:
- 一项诊断准确性研究,比较定量BAL培养与BFPP测试.
- 包括在3年的时间里被直管的创伤和手术患者,怀疑肺炎.
- 使用麦克纳马分析来比较诊断测试结果.
主要成果:
- 分析了来自151名患者的238个BAL.
- 肺炎被定义为≥10^5殖民地形成单位/毫升在BAL.
- BFPP的结果与定量培养发现相关.
结论:
- 10^6基因组拷贝数/毫升的BFPP切割值对于启动向抗生素治疗具有敏感性和特异性.
- 负的BFPP结果具有很高的负预测值 (99.8%),可能会限制不必要的经验性抗生素使用.
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