Cihan Papan1,2, Melanie Meyer-Buehn3, Gudrun Laniado3, Thomas Nicolai3, Matthias Griese3, Johannes Huebner3. 1. University Children's Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilians University, Lindwurmstr. 4, 80337, Munich, Germany. cihan.papan@medma.uni-heidelberg.de. 2. Pediatric Infectious Diseases, Medical Faculty Mannheim, University Children's Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. cihan.papan@medma.uni-heidelberg.de. 3. University Children's Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilians University, Lindwurmstr. 4, 80337, Munich, Germany.
Abstract
BACKGROUND: Pneumonia is a major healthcare problem. Rapid pathogen identification is critical, but often delayed due to the duration of culturing. Early, broad antibacterial therapy might lead to false-negative culture findings and eventually to the development of antibiotic resistances. We aimed to assess the accuracy of the new application Unyvero P50 based on multiplex PCR to detect bacterial pathogens in respiratory specimens from children and neonates. METHODS: In this prospective study, bronchoalveolar lavage fluids, tracheal aspirates, or pleural fluids from neonates and children were analyzed by both traditional culture methods and Unyvero multiplex PCR. RESULTS: We analyzed specimens from 79 patients with a median age of 1.8 (range 0.01-20.1). Overall, Unyvero yielded a sensitivity of 73.1% and a specificity of 97.9% compared to culture methods. Best results were observed for non-fermenting bacteria, for which sensitivity of Unyvero was 90% and specificity 97.3%, while rates were lower for Gram-positive bacteria (46.2 and 93.9%, respectively). For resistance genes, we observed a concordance with antibiogram of 75% for those specimens in which there was a cultural correlate. CONCLUSIONS: Unyvero is a fast and easy-to-use tool that might provide additional information for clinical decision making, especially in neonates and in the setting of nosocomial pneumonia. Sensitivity of the PCR for Gram-positive bacteria and important resistance genes must be improved before this application can be widely recommended.
BACKGROUND:Pneumonia is a major healthcare problem. Rapid pathogen identification is critical, but often delayed due to the duration of culturing. Early, broad antibacterial therapy might lead to false-negative culture findings and eventually to the development of antibiotic resistances. We aimed to assess the accuracy of the new application Unyvero P50 based on multiplex PCR to detect bacterial pathogens in respiratory specimens from children and neonates. METHODS: In this prospective study, bronchoalveolar lavage fluids, tracheal aspirates, or pleural fluids from neonates and children were analyzed by both traditional culture methods and Unyvero multiplex PCR. RESULTS: We analyzed specimens from 79 patients with a median age of 1.8 (range 0.01-20.1). Overall, Unyvero yielded a sensitivity of 73.1% and a specificity of 97.9% compared to culture methods. Best results were observed for non-fermenting bacteria, for which sensitivity of Unyvero was 90% and specificity 97.3%, while rates were lower for Gram-positive bacteria (46.2 and 93.9%, respectively). For resistance genes, we observed a concordance with antibiogram of 75% for those specimens in which there was a cultural correlate. CONCLUSIONS: Unyvero is a fast and easy-to-use tool that might provide additional information for clinical decision making, especially in neonates and in the setting of nosocomial pneumonia. Sensitivity of the PCR for Gram-positive bacteria and important resistance genes must be improved before this application can be widely recommended.
Authors: Michael Harris; Julia Clark; Nicky Coote; Penny Fletcher; Anthony Harnden; Michael McKean; Anne Thomson Journal: Thorax Date: 2011-10 Impact factor: 9.139
Authors: Seema Jain; Derek J Williams; Sandra R Arnold; Krow Ampofo; Anna M Bramley; Carrie Reed; Chris Stockmann; Evan J Anderson; Carlos G Grijalva; Wesley H Self; Yuwei Zhu; Anami Patel; Weston Hymas; James D Chappell; Robert A Kaufman; J Herman Kan; David Dansie; Noel Lenny; David R Hillyard; Lia M Haynes; Min Levine; Stephen Lindstrom; Jonas M Winchell; Jacqueline M Katz; Dean Erdman; Eileen Schneider; Lauri A Hicks; Richard G Wunderink; Kathryn M Edwards; Andrew T Pavia; Jonathan A McCullers; Lyn Finelli Journal: N Engl J Med Date: 2015-02-26 Impact factor: 91.245
Authors: Latania K Logan; John P Renschler; Sumanth Gandra; Robert A Weinstein; Ramanan Laxminarayan Journal: Emerg Infect Dis Date: 2015-11 Impact factor: 6.883
Authors: Li Liu; Shefali Oza; Dan Hogan; Yue Chu; Jamie Perin; Jun Zhu; Joy E Lawn; Simon Cousens; Colin Mathers; Robert E Black Journal: Lancet Date: 2016-11-11 Impact factor: 79.321
Authors: Naomi J Gadsby; Martin P McHugh; Callum Forbes; Laura MacKenzie; Stephen K D Hamilton; David M Griffith; Kate E Templeton Journal: Eur J Clin Microbiol Infect Dis Date: 2019-03-11 Impact factor: 3.267
Authors: Matthias Klein; Johannes Bacher; Sandra Barth; Faranak Atrzadeh; Katja Siebenhaller; Inês Ferreira; Stephan Beisken; Andreas E Posch; Karen C Carroll; Richard G Wunderink; Chao Qi; Fann Wu; Dwight J Hardy; Robin Patel; Matthew D Sims Journal: J Clin Microbiol Date: 2021-02-18 Impact factor: 5.948
Authors: Abdul Kr Purba; Purwantyastuti Ascobat; Armen Muchtar; Laksmi Wulandari; Alfian Nur Rosyid; Priyo Budi Purwono; Tjip S van der Werf; Alex W Friedrich; Maarten J Postma Journal: Infect Drug Resist Date: 2019-11-25 Impact factor: 4.003