scholarly journals Outcomes in lower respiratory tract infections and the impact of antimicrobial drug resistance

2002 ◽  
Vol 8 ◽  
pp. 1-11 ◽  
Author(s):  
Joshua P. Metlay ◽  
Daniel E. Singer
Keyword(s):  
Drug Resistance ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antimicrobial Drug ◽  
Lower Respiratory Tract Infections ◽  
Antimicrobial Drug Resistance ◽  
Tract Infections ◽  
The Impact

scholarly journals Practical Comparison of the BioFire FilmArray Pneumonia Panel to Routine Diagnostic Methods and Potential Impact on Antimicrobial Stewardship in Adult Hospitalized Patients with Lower Respiratory Tract Infections

2020 ◽  
Vol 58 (7) ◽  
Author(s):  
Blake W. Buchan ◽  
Sam Windham ◽  
Joan-Miquel Balada-Llasat ◽  
Amy Leber ◽  
Amanda Harrington ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Diagnostic Methods ◽  
Lower Respiratory Tract Infections ◽  
Percent Agreement ◽  
Tract Infections ◽  
Hospital Acquired ◽  
The Impact ◽  
Antibiotic Agents

ABSTRACT Lower respiratory tract infections, including hospital-acquired and ventilator-associated pneumonia, are common in hospitalized patient populations. Standard methods frequently fail to identify the infectious etiology due to the polymicrobial nature of respiratory specimens and the necessity of ordering specific tests to identify viral agents. The potential severity of these infections combined with a failure to clearly identify the causative pathogen results in administration of empirical antibiotic agents based on clinical presentation and other risk factors. We examined the impact of the multiplexed, semiquantitative BioFire FilmArray Pneumonia panel (PN panel) test on laboratory reporting for 259 adult inpatients submitting bronchoalveolar lavage (BAL) specimens for laboratory analysis. The PN panel demonstrated a combined 96.2% positive percent agreement (PPA) and 98.1% negative percent agreement (NPA) for the qualitative identification of 15 bacterial targets compared to routine bacterial culture. Semiquantitative values reported by the PN panel were frequently higher than values reported by culture, resulting in semiquantitative agreement (within the same log10 value) of 43.6% between the PN panel and culture; however, all bacterial targets reported as >105 CFU/ml in culture were reported as ≥105 genomic copies/ml by the PN panel. Viral targets were identified by the PN panel in 17.7% of specimens tested, of which 39.1% were detected in conjunction with a bacterial target. A review of patient medical records, including clinically prescribed antibiotics, revealed the potential for antibiotic adjustment in 70.7% of patients based on the PN panel result, including discontinuation or de-escalation in 48.2% of patients, resulting in an average savings of 6.2 antibiotic days/patient.

Association of serum sphingomyelin profile with clinical outcomes in patients with lower respiratory tract infections: results of an observational, prospective 6-year follow-up study

2019 ◽  
Vol 57 (5) ◽  
pp. 679-689
Author(s):  
Thomas Baumgartner ◽  
Giedre Zurauskaite ◽  
Christian Steuer ◽  
Luca Bernasconi ◽  
Andreas Huber ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Short Term ◽  
Inflammatory Conditions ◽  
Tract Infections ◽  
The Impact

Abstract Background Sphingolipids – the structural cell membrane components – and their metabolites are involved in signal transduction and participate in the regulation of immunity. We investigated the prognostic implications of sphingolipid metabolic profiling on mortality in a large cohort of patients with lower respiratory tract infections (LRTIs). Methods We measured 15 different sphingomyelin (SM) types in patients with LRTIs from a previous Swiss multicenter trial that examined the impact of procalcitonin-guided antibiotic therapy on total antibiotic use and rates and duration of hospitalization. Primary and secondary end points were adverse outcomes – defined as death or intensive care unit admission within 30 days – and 6-year mortality. Results Of 360 patients, 8.9% experienced an adverse outcome within 30 days and 46% died within 6 years. Levels of all SM types were significantly lower in pneumonia patients vs. those with chronic obstructive pulmonary disease (COPD) exacerbation (p<0.0001 for all comparisons). Sphingomyelin subspecies SM (OH) C22:1 and SM (OH) C22:2 were associated with lower risk for short-term adverse outcomes (sex-, gender- and comorbidity-adjusted odds ratios [OR]: 0.036; 95% confidence interval [CI], 0.002–0.600; p=0.021 and 0.037; 95% CI, 0.001–0.848; p=0.039, respectively). We found no significant associations with 6-year mortality for any SM. Conclusions Circulating sphingolipid levels are lower in inflammatory conditions such as pneumonia and correlate with adverse short-term outcomes. Further characterization of the physiological, pathophysiological and metabolic roles of sphingolipids under inflammatory conditions may facilitate understanding of their roles in infectious disease.

scholarly journals The Diagnostic Value of Metagenomic Next–Generation Sequencing in Lower Respiratory Tract Infection

2021 ◽  
Vol 11 ◽  
Author(s):  
Yan Zheng ◽  
Xiaojian Qiu ◽  
Ting Wang ◽  
Jie Zhang
Keyword(s):  
Next Generation Sequencing ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Diagnostic Value ◽  
Next Generation ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
The Impact ◽  
Generation Sequencing

Lower respiratory tract infections are associated with high morbidity and mortality and significant clinical harm. Due to the limited ability of traditional pathogen detection methods, anti-infective therapy is mostly empirical. Therefore, it is difficult to adopt targeted drug therapy. In recent years, metagenomic next-generation sequencing (mNGS) technology has provided a promising means for pathogen-specific diagnosis and updated the diagnostic strategy for lower respiratory tract infections. This article reviews the diagnostic value of mNGS for lower respiratory tract infections, the impact of different sampling methods on the detection efficiency of mNGS, and current technical difficulties in the clinical application of mNGS.

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