Multiplex Respiratory Virus Testing for Antimicrobial Stewardship: A Prospective Assessment of Antimicrobial Use and Clinical Outcomes Among Hospitalized Adults.
Identifieur interne : 000090 ( Main/Exploration ); précédent : 000089; suivant : 000091Multiplex Respiratory Virus Testing for Antimicrobial Stewardship: A Prospective Assessment of Antimicrobial Use and Clinical Outcomes Among Hospitalized Adults.
Auteurs : Makeda Semret ; Ian Schiller ; Barbara Ann Jardin ; Charles Frenette ; Vivian G. Loo ; Jesse Papenburg ; Shelly A. Mcneil [Canada] ; Nandini DendukuriSource :
- The Journal of infectious diseases [ 1537-6613 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Anti-infectieux (usage thérapeutique), Antiviraux (usage thérapeutique), Canada, Femelle, Hospitalisation, Humains, Infections de l'appareil respiratoire (diagnostic), Infections de l'appareil respiratoire (traitement médicamenteux), Infections de l'appareil respiratoire (virologie), Maladies virales (diagnostic), Maladies virales (traitement médicamenteux), Maladies virales (virologie), Mâle, Partie nasale du pharynx (virologie), Réaction de polymérisation en chaine multiplex, Sujet âgé, Sujet âgé de 80 ans ou plus, Virus (génétique), Virus (isolement et purification), Études prospectives.
- MESH :
- diagnostic : Infections de l'appareil respiratoire, Maladies virales.
- génétique : Virus.
- isolement et purification : Virus.
- traitement médicamenteux : Infections de l'appareil respiratoire, Maladies virales.
- usage thérapeutique : Anti-infectieux, Antiviraux.
- virologie : Infections de l'appareil respiratoire, Maladies virales, Partie nasale du pharynx.
- Adulte d'âge moyen, Canada, Femelle, Hospitalisation, Humains, Mâle, Réaction de polymérisation en chaine multiplex, Sujet âgé, Sujet âgé de 80 ans ou plus, Études prospectives.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Anti-Infective Agents (therapeutic use), Antimicrobial Stewardship, Antiviral Agents (therapeutic use), Canada, Female, Hospitalization, Humans, Male, Middle Aged, Multiplex Polymerase Chain Reaction, Nasopharynx (virology), Prospective Studies, Respiratory Tract Infections (diagnosis), Respiratory Tract Infections (drug therapy), Respiratory Tract Infections (virology), Virus Diseases (diagnosis), Virus Diseases (drug therapy), Virus Diseases (virology), Viruses (genetics), Viruses (isolation & purification).
- MESH :
- chemical , therapeutic use : Anti-Infective Agents, Antiviral Agents.
- diagnosis : Respiratory Tract Infections, Virus Diseases.
- drug therapy : Respiratory Tract Infections, Virus Diseases.
- genetics : Viruses.
- isolation & purification : Viruses.
- virology : Nasopharynx, Respiratory Tract Infections, Virus Diseases.
- Aged, Aged, 80 and over, Antimicrobial Stewardship, Canada, Female, Hospitalization, Humans, Male, Middle Aged, Multiplex Polymerase Chain Reaction, Prospective Studies.
Abstract
Background
Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults.
Methods
Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada. The primary outcome measure was change in antimicrobial prescriptions (ie, de-escalation of empirical antimicrobial therapy or commencement of new antimicrobial therapy) after RVP results were available. Clinical outcomes were also assessed.
Results
Influenza virus was identified in 53% of individuals in the study population, and other viruses were identified in 10%. Influenza virus positivity was associated with shorter duration of hospitalization and appropriate antiviral management. Antibiotic management was most significantly correlated with radiographic suspicion of pneumonia and less so with results of the RVP. Positivity for viruses other than influenza virus was not correlated with significantly different outcomes.
Conclusions
Physicians respond to results of testing for influenza virus when managing hospitalized adult patients but respond less to test results for other viruses. These data can inform the design of stewardship interventions and the selection of viral testing panels for hospitalized patients.
DOI: 10.1093/infdis/jix288
PubMed: 29149338
Affiliations:
Links toward previous steps (curation, corpus...)
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virales</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anti-infectieux</term><term>Antiviraux</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections de l'appareil respiratoire</term><term>Maladies virales</term><term>Partie nasale du pharynx</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Nasopharynx</term><term>Respiratory Tract Infections</term><term>Virus Diseases</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Antimicrobial Stewardship</term><term>Canada</term><term>Female</term><term>Hospitalization</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multiplex Polymerase Chain Reaction</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Canada</term><term>Femelle</term><term>Hospitalisation</term><term>Humains</term><term>Mâle</term><term>Réaction de polymérisation en chaine multiplex</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada. The primary outcome measure was change in antimicrobial prescriptions (ie, de-escalation of empirical antimicrobial therapy or commencement of new antimicrobial therapy) after RVP results were available. Clinical outcomes were also assessed.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Influenza virus was identified in 53% of individuals in the study population, and other viruses were identified in 10%. Influenza virus positivity was associated with shorter duration of hospitalization and appropriate antiviral management. Antibiotic management was most significantly correlated with radiographic suspicion of pneumonia and less so with results of the RVP. Positivity for viruses other than influenza virus was not correlated with significantly different outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions</b></p><p>Physicians respond to results of testing for influenza virus when managing hospitalized adult patients but respond less to test results for other viruses. These data can inform the design of stewardship interventions and the selection of viral testing panels for hospitalized patients.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29149338</PMID><DateCompleted><Year>2017</Year><Month>12</Month><Day>13</Day></DateCompleted><DateRevised><Year>2020</Year><Month>04</Month><Day>03</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1537-6613</ISSN><JournalIssue CitedMedium="Internet"><Volume>216</Volume><Issue>8</Issue><PubDate><Year>2017</Year><Month>11</Month><Day>15</Day></PubDate></JournalIssue><Title>The Journal of infectious diseases</Title><ISOAbbreviation>J. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Multiplex Respiratory Virus Testing for Antimicrobial Stewardship: A Prospective Assessment of Antimicrobial Use and Clinical Outcomes Among Hospitalized Adults.</ArticleTitle><Pagination><MedlinePgn>936-944</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/infdis/jix288</ELocationID><Abstract><AbstractText Label="Background">Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults.</AbstractText><AbstractText Label="Methods">Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada. The primary outcome measure was change in antimicrobial prescriptions (ie, de-escalation of empirical antimicrobial therapy or commencement of new antimicrobial therapy) after RVP results were available. Clinical outcomes were also assessed.</AbstractText><AbstractText Label="Results">Influenza virus was identified in 53% of individuals in the study population, and other viruses were identified in 10%. Influenza virus positivity was associated with shorter duration of hospitalization and appropriate antiviral management. Antibiotic management was most significantly correlated with radiographic suspicion of pneumonia and less so with results of the RVP. Positivity for viruses other than influenza virus was not correlated with significantly different outcomes.</AbstractText><AbstractText Label="Conclusions">Physicians respond to results of testing for influenza virus when managing hospitalized adult patients but respond less to test results for other viruses. These data can inform the design of stewardship interventions and the selection of viral testing panels for hospitalized patients.</AbstractText><CopyrightInformation>© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Semret</LastName><ForeName>Makeda</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Division of Infectious diseases and Medical Microbiology, Department of Medicine and Laboratories.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schiller</LastName><ForeName>Ian</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Research Institute.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jardin</LastName><ForeName>Barbara Ann</ForeName><Initials>BA</Initials><AffiliationInfo><Affiliation>Research Institute.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Frenette</LastName><ForeName>Charles</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Division of Infectious diseases and Medical Microbiology, Department of Medicine and Laboratories.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loo</LastName><ForeName>Vivian G</ForeName><Initials>VG</Initials><AffiliationInfo><Affiliation>Division of Infectious diseases and Medical Microbiology, Department of Medicine and Laboratories.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Papenburg</LastName><ForeName>Jesse</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Infectious diseases and Medical Microbiology, Department of Medicine and Laboratories.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McNeil</LastName><ForeName>Shelly A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dendukuri</LastName><ForeName>Nandini</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Technology Assessment Unit, McGill University Health Centre, Montreal, Québec.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>CIHR</Agency><Country>Canada</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Infect Dis</MedlineTA><NlmUniqueID>0413675</NlmUniqueID><ISSNLinking>0022-1899</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000890">Anti-Infective Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Infect Dis. 2017 Nov 15;216(8):923-925</RefSource><PMID Version="1">28633488</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000890" MajorTopicYN="N">Anti-Infective Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073602" MajorTopicYN="Y">Antimicrobial Stewardship</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N">Canada</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D060885" MajorTopicYN="N">Multiplex Polymerase Chain Reaction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009305" MajorTopicYN="N">Nasopharynx</DescriptorName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014777" MajorTopicYN="N">Virus Diseases</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014780" MajorTopicYN="N">Viruses</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">adult</Keyword><Keyword MajorTopicYN="Y">antimicrobial stewardship</Keyword><Keyword MajorTopicYN="Y">respiratory virus testing</Keyword><Keyword MajorTopicYN="Y">respiratory viruses</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>04</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>06</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>11</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>11</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>12</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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