Clin Microbiol Infect:分子POCT检测呼吸道病毒和非典型病原体有助于减少住院LRTI患者抗生素的使用

2020-07-28 MedSci原创 MedSci原创

本研究旨在评估与常规实时PCR相比,在常规实时PCR中添加病毒和非典型病原体的分子点检测(POCT)是否可以减少下呼吸道感染(LRTI)住院患者的静脉注射抗生素时间。

本研究旨在评估与常规实时PCR相比,在常规实时PCR中添加病毒和非典型病原体的分子点检测(POCT)是否可以减少下呼吸道感染(LRTI)住院患者的静脉注射抗生素时间。

 

在这项单中心、开放标签、随机对照研究中,我们纳入了被诊断为LRTI的住院成人,将其随机分为干预组(POCT FilmArray Panel检测20种病毒、非典型病原体和细菌加上常规实时PCR)或对照组(常规实时PCR检测10种病原体)。主要结果是住院期间静脉注射抗生素的时间。次要结果包括住院时间、住院费用和72小时内及72小时至7天之间的排异情况。采用意向性治疗分析。

 

结果,在2017年10月至2018年7月期间,我们招募了800名符合条件的患者(干预组398名,对照组402名)。干预组静脉注射抗生素的时间比对照组短(7.0天(四分位数范围(IQR)5.0-9.0) VS. 8.0天(IQR 6.0-11.0);P <0.001)。干预组的住院时间显著缩短(8.0天(IQR 7.0-11.0)VS. 9.0天(IQR 7.0-12.0);p<0.001),干预组的住院费用显著低于对照组(1804.7元(IQR 1298.4-2633.8)VS. 2042.5元(IQR 1427.4-2926.2);p 0.002)。干预组更多的患者在72小时内(7.9%,29/367 VS. 3.2%,12/377;p 0.005)和72小时至7天之间(29.7%,109/367 VS. 22.0%,83/377;p 0.024)实现了脱毒。

 

综上所述,该研究结果表明,使用分子POCT检测呼吸道病毒和非典型病原体可能有助于减少住院LRTI患者的静脉抗生素使用。

 

原始出处:

 

D ShengchenX Gu, et al., Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial. Clin Microbiol Infect. 2019 Nov;25(11):1415-1421. doi: 10.1016/j.cmi.2019.06.012.

 

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    2021-01-26 sunylz
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    2020-11-17 xjy02
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    2021-02-22 habb
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1919107, encodeId=838f191910eec, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Jan 26 20:56:13 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857894, encodeId=d0c6185e8949a, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Mon Mar 29 06:56:13 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084597, encodeId=a146208459e55, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Tue Nov 17 08:56:13 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858352, encodeId=f349185835239, content=<a href='/topic/show?id=21311323521' target=_blank style='color:#2F92EE;'>#OCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13235, encryptionId=21311323521, topicName=OCT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Feb 22 19:56:13 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767779, encodeId=61851e67779bd, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Fri May 14 00:56:13 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282537, encodeId=9866128253e98, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492626, encodeId=45b01492626ad, content=<a href='/topic/show?id=9b7c9929363' target=_blank style='color:#2F92EE;'>#非典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99293, encryptionId=9b7c9929363, topicName=非典型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb98946820, createdName=sjzlzc010, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510665, encodeId=612c15106652f, content=<a href='/topic/show?id=2efbe0807b1' target=_blank style='color:#2F92EE;'>#病原体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70807, encryptionId=2efbe0807b1, topicName=病原体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6c210226313, createdName=xue8605, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
    2020-07-30 zhmscau
  7. [GetPortalCommentsPageByObjectIdResponse(id=1919107, encodeId=838f191910eec, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Jan 26 20:56:13 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857894, encodeId=d0c6185e8949a, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Mon Mar 29 06:56:13 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084597, encodeId=a146208459e55, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Tue Nov 17 08:56:13 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858352, encodeId=f349185835239, content=<a href='/topic/show?id=21311323521' target=_blank style='color:#2F92EE;'>#OCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13235, encryptionId=21311323521, topicName=OCT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Feb 22 19:56:13 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767779, encodeId=61851e67779bd, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Fri May 14 00:56:13 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282537, encodeId=9866128253e98, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492626, encodeId=45b01492626ad, content=<a href='/topic/show?id=9b7c9929363' target=_blank style='color:#2F92EE;'>#非典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99293, encryptionId=9b7c9929363, topicName=非典型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb98946820, createdName=sjzlzc010, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510665, encodeId=612c15106652f, content=<a href='/topic/show?id=2efbe0807b1' target=_blank style='color:#2F92EE;'>#病原体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70807, encryptionId=2efbe0807b1, topicName=病原体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6c210226313, createdName=xue8605, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1919107, encodeId=838f191910eec, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Tue Jan 26 20:56:13 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1857894, encodeId=d0c6185e8949a, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Mon Mar 29 06:56:13 CST 2021, time=2021-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084597, encodeId=a146208459e55, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Tue Nov 17 08:56:13 CST 2020, time=2020-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1858352, encodeId=f349185835239, content=<a href='/topic/show?id=21311323521' target=_blank style='color:#2F92EE;'>#OCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13235, encryptionId=21311323521, topicName=OCT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Feb 22 19:56:13 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767779, encodeId=61851e67779bd, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Fri May 14 00:56:13 CST 2021, time=2021-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282537, encodeId=9866128253e98, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492626, encodeId=45b01492626ad, content=<a href='/topic/show?id=9b7c9929363' target=_blank style='color:#2F92EE;'>#非典型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99293, encryptionId=9b7c9929363, topicName=非典型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb98946820, createdName=sjzlzc010, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510665, encodeId=612c15106652f, content=<a href='/topic/show?id=2efbe0807b1' target=_blank style='color:#2F92EE;'>#病原体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70807, encryptionId=2efbe0807b1, topicName=病原体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f6c210226313, createdName=xue8605, createdTime=Thu Jul 30 01:56:13 CST 2020, time=2020-07-30, status=1, ipAttribution=)]
    2020-07-30 xue8605

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