Session Type: 1-hour ePoster Review
Session Title: 1-hour ePoster Review
Authors(s): S. Bergese (1), B. Fox (1), N. García Allende (2), M.E. Elisiri (1), A.E. Schneider (1), I. Maldonado (1), J. Ruiz (3), S. Gonzalez Fraga (4), V. Rodriguez (2), L. Fernandez-Canigia (1)
Authors Affiliations(s): (1) Sector Microbiología, Laboratorio Central Hospital Alemán, Argentina, (2) Servicio Infectología y Epidemiología hospitalaria; Hospital Alemán, Argentina, (3) Servicio de Clínica Médica, Hospital Alemán, Argentina, (4) Laboratorio Central Hospital Alemán, Argentina
Background:
Rapid and definitive diagnosis is critical in the management of respiratory tract infections, especially in immunocompromised hosts. This study was designed to assess whether the implementation of a multiplex molecular respiratory panel (FilmArray) (FRP) has an impact on immunocompromised patient standard care in a general hospital.
Methods:This is a single-centre, retrospective, before-after study.
Periods: April 2017 to May 2018, before the implementation (Pre-FRP), and from January 2019 to July 2019, after (Post-FRP).
Inclusion criteria: adult patients immunosuppressed due to solid organ or stem cell transplantation, active oncological disease, HIV positive and/or chronic use of immunosuppressive medication with suspected upper or lower acute respiratory illness tested by at least one of the following diagnostic methods:
Pre-FRP: a)Direct immunofluorescence for Adenovirus, Influenza A and B, Respiratory Syncytial Virus, Metapneumovirus, and Parainfluenza 1, 2 and 3; b)Mycoplasma pneumoniae and/or Chlamydophila pneumoniae antibodies; c)Influenza(H1N1 and A), Adenovirus, Mycoplasma and/or Chlamydophila pneumoniae real-time PCR.
Post-FRP: FilmArray™ Respiratory Panelv1.7.
The primary outcome was the reduction in antimicrobial agent prescriptions.
The sample size was calculated to detect a reduction in antibiotic use of 30% with a statistical power of 80% and a significance level of 0.05. InfoStat software was used for statistical analysis.
Results:A total of 116 patients were included, 58 in each group. The positive detection rate was significantly higher in the post-FRP vs. the pre-FRP. (30 (52%) vs 7 (12%) respectively; p= 0.0001) mainly due to rhino/enterovirus. There were more patients with antimicrobial treatment in pre-FRP vs post-FRP (95% vs 72%, p 0.001); more patients treated with beta-lactams and macrolides (52 vs 34, p0.0001; 25 vs 3 p 0.0001, respectively) and no differences in patients treated with oseltamivir. There was a more appropriate de-escalation in pre-FRP (18 vs 5 p 0,001) and a more appropriate escalation in post-FRP (0 vs 6, p0.02). No significant differences in the use of isolation facilities, the number of inpatients, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, and 30-day mortality were observed.
Conclusions:The FRP impacted on patient care by improving the diagnostic yield and by optimizing antimicrobial treatment in immunosuppressed adult patients.
Keyword(s): Filmarray Respiratory Panel, Syndromic testing, Immunocompromised patientsCOI Institutional Grants: Yes
Session Type: 1-hour ePoster Review
Session Title: 1-hour ePoster Review
Authors(s): S. Bergese (1), B. Fox (1), N. García Allende (2), M.E. Elisiri (1), A.E. Schneider (1), I. Maldonado (1), J. Ruiz (3), S. Gonzalez Fraga (4), V. Rodriguez (2), L. Fernandez-Canigia (1)
Authors Affiliations(s): (1) Sector Microbiología, Laboratorio Central Hospital Alemán, Argentina, (2) Servicio Infectología y Epidemiología hospitalaria; Hospital Alemán, Argentina, (3) Servicio de Clínica Médica, Hospital Alemán, Argentina, (4) Laboratorio Central Hospital Alemán, Argentina
Background:
Rapid and definitive diagnosis is critical in the management of respiratory tract infections, especially in immunocompromised hosts. This study was designed to assess whether the implementation of a multiplex molecular respiratory panel (FilmArray) (FRP) has an impact on immunocompromised patient standard care in a general hospital.
Methods:This is a single-centre, retrospective, before-after study.
Periods: April 2017 to May 2018, before the implementation (Pre-FRP), and from January 2019 to July 2019, after (Post-FRP).
Inclusion criteria: adult patients immunosuppressed due to solid organ or stem cell transplantation, active oncological disease, HIV positive and/or chronic use of immunosuppressive medication with suspected upper or lower acute respiratory illness tested by at least one of the following diagnostic methods:
Pre-FRP: a)Direct immunofluorescence for Adenovirus, Influenza A and B, Respiratory Syncytial Virus, Metapneumovirus, and Parainfluenza 1, 2 and 3; b)Mycoplasma pneumoniae and/or Chlamydophila pneumoniae antibodies; c)Influenza(H1N1 and A), Adenovirus, Mycoplasma and/or Chlamydophila pneumoniae real-time PCR.
Post-FRP: FilmArray™ Respiratory Panelv1.7.
The primary outcome was the reduction in antimicrobial agent prescriptions.
The sample size was calculated to detect a reduction in antibiotic use of 30% with a statistical power of 80% and a significance level of 0.05. InfoStat software was used for statistical analysis.
Results:A total of 116 patients were included, 58 in each group. The positive detection rate was significantly higher in the post-FRP vs. the pre-FRP. (30 (52%) vs 7 (12%) respectively; p= 0.0001) mainly due to rhino/enterovirus. There were more patients with antimicrobial treatment in pre-FRP vs post-FRP (95% vs 72%, p 0.001); more patients treated with beta-lactams and macrolides (52 vs 34, p0.0001; 25 vs 3 p 0.0001, respectively) and no differences in patients treated with oseltamivir. There was a more appropriate de-escalation in pre-FRP (18 vs 5 p 0,001) and a more appropriate escalation in post-FRP (0 vs 6, p0.02). No significant differences in the use of isolation facilities, the number of inpatients, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, and 30-day mortality were observed.
Conclusions:The FRP impacted on patient care by improving the diagnostic yield and by optimizing antimicrobial treatment in immunosuppressed adult patients.
Keyword(s): Filmarray Respiratory Panel, Syndromic testing, Immunocompromised patientsCOI Institutional Grants: Yes
Session Type: 1-hour ePoster Review
Session Title: 1-hour ePoster Review
Authors(s): S. Bergese (1), B. Fox (1), N. García Allende (2), M.E. Elisiri (1), A.E. Schneider (1), I. Maldonado (1), J. Ruiz (3), S. Gonzalez Fraga (4), V. Rodriguez (2), L. Fernandez-Canigia (1)
Authors Affiliations(s): (1) Sector Microbiología, Laboratorio Central Hospital Alemán, Argentina, (2) Servicio Infectología y Epidemiología hospitalaria; Hospital Alemán, Argentina, (3) Servicio de Clínica Médica, Hospital Alemán, Argentina, (4) Laboratorio Central Hospital Alemán, Argentina
Background:
Rapid and definitive diagnosis is critical in the management of respiratory tract infections, especially in immunocompromised hosts. This study was designed to assess whether the implementation of a multiplex molecular respiratory panel (FilmArray) (FRP) has an impact on immunocompromised patient standard care in a general hospital.
Methods:This is a single-centre, retrospective, before-after study.
Periods: April 2017 to May 2018, before the implementation (Pre-FRP), and from January 2019 to July 2019, after (Post-FRP).
Inclusion criteria: adult patients immunosuppressed due to solid organ or stem cell transplantation, active oncological disease, HIV positive and/or chronic use of immunosuppressive medication with suspected upper or lower acute respiratory illness tested by at least one of the following diagnostic methods:
Pre-FRP: a)Direct immunofluorescence for Adenovirus, Influenza A and B, Respiratory Syncytial Virus, Metapneumovirus, and Parainfluenza 1, 2 and 3; b)Mycoplasma pneumoniae and/or Chlamydophila pneumoniae antibodies; c)Influenza(H1N1 and A), Adenovirus, Mycoplasma and/or Chlamydophila pneumoniae real-time PCR.
Post-FRP: FilmArray™ Respiratory Panelv1.7.
The primary outcome was the reduction in antimicrobial agent prescriptions.
The sample size was calculated to detect a reduction in antibiotic use of 30% with a statistical power of 80% and a significance level of 0.05. InfoStat software was used for statistical analysis.
Results:A total of 116 patients were included, 58 in each group. The positive detection rate was significantly higher in the post-FRP vs. the pre-FRP. (30 (52%) vs 7 (12%) respectively; p= 0.0001) mainly due to rhino/enterovirus. There were more patients with antimicrobial treatment in pre-FRP vs post-FRP (95% vs 72%, p 0.001); more patients treated with beta-lactams and macrolides (52 vs 34, p0.0001; 25 vs 3 p 0.0001, respectively) and no differences in patients treated with oseltamivir. There was a more appropriate de-escalation in pre-FRP (18 vs 5 p 0,001) and a more appropriate escalation in post-FRP (0 vs 6, p0.02). No significant differences in the use of isolation facilities, the number of inpatients, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, and 30-day mortality were observed.
Conclusions:The FRP impacted on patient care by improving the diagnostic yield and by optimizing antimicrobial treatment in immunosuppressed adult patients.
Keyword(s): Filmarray Respiratory Panel, Syndromic testing, Immunocompromised patientsCOI Institutional Grants: Yes
Session Type: 1-hour ePoster Review
Session Title: 1-hour ePoster Review
Authors(s): S. Bergese (1), B. Fox (1), N. García Allende (2), M.E. Elisiri (1), A.E. Schneider (1), I. Maldonado (1), J. Ruiz (3), S. Gonzalez Fraga (4), V. Rodriguez (2), L. Fernandez-Canigia (1)
Authors Affiliations(s): (1) Sector Microbiología, Laboratorio Central Hospital Alemán, Argentina, (2) Servicio Infectología y Epidemiología hospitalaria; Hospital Alemán, Argentina, (3) Servicio de Clínica Médica, Hospital Alemán, Argentina, (4) Laboratorio Central Hospital Alemán, Argentina
Background:
Rapid and definitive diagnosis is critical in the management of respiratory tract infections, especially in immunocompromised hosts. This study was designed to assess whether the implementation of a multiplex molecular respiratory panel (FilmArray) (FRP) has an impact on immunocompromised patient standard care in a general hospital.
Methods:This is a single-centre, retrospective, before-after study.
Periods: April 2017 to May 2018, before the implementation (Pre-FRP), and from January 2019 to July 2019, after (Post-FRP).
Inclusion criteria: adult patients immunosuppressed due to solid organ or stem cell transplantation, active oncological disease, HIV positive and/or chronic use of immunosuppressive medication with suspected upper or lower acute respiratory illness tested by at least one of the following diagnostic methods:
Pre-FRP: a)Direct immunofluorescence for Adenovirus, Influenza A and B, Respiratory Syncytial Virus, Metapneumovirus, and Parainfluenza 1, 2 and 3; b)Mycoplasma pneumoniae and/or Chlamydophila pneumoniae antibodies; c)Influenza(H1N1 and A), Adenovirus, Mycoplasma and/or Chlamydophila pneumoniae real-time PCR.
Post-FRP: FilmArray™ Respiratory Panelv1.7.
The primary outcome was the reduction in antimicrobial agent prescriptions.
The sample size was calculated to detect a reduction in antibiotic use of 30% with a statistical power of 80% and a significance level of 0.05. InfoStat software was used for statistical analysis.
Results:A total of 116 patients were included, 58 in each group. The positive detection rate was significantly higher in the post-FRP vs. the pre-FRP. (30 (52%) vs 7 (12%) respectively; p= 0.0001) mainly due to rhino/enterovirus. There were more patients with antimicrobial treatment in pre-FRP vs post-FRP (95% vs 72%, p 0.001); more patients treated with beta-lactams and macrolides (52 vs 34, p0.0001; 25 vs 3 p 0.0001, respectively) and no differences in patients treated with oseltamivir. There was a more appropriate de-escalation in pre-FRP (18 vs 5 p 0,001) and a more appropriate escalation in post-FRP (0 vs 6, p0.02). No significant differences in the use of isolation facilities, the number of inpatients, hospital length of stay (LOS), admission to intensive care unit (ICU), LOS in ICU, and 30-day mortality were observed.
Conclusions:The FRP impacted on patient care by improving the diagnostic yield and by optimizing antimicrobial treatment in immunosuppressed adult patients.
Keyword(s): Filmarray Respiratory Panel, Syndromic testing, Immunocompromised patientsCOI Institutional Grants: Yes