Kantonsspital St.Gallen
login

Impact of viral multiplex real-time PCR on management of respiratory tract infection: a retrospective cohort study

Lena M Mayer, Christian R. Kahlert, Frank Rassouli, Pietro Vernazza & Werner Albrich

abstract

BACKGROUND
Significance and clinical utility of multiple virus detection by multiplex real-time polymerase chain reaction (rtPCR) in respiratory tract infection remain unclear.

METHODS
This retrospective cohort study analyzed how virus detection affected clinical management. During a 27-month period, clinical and laboratory information was collected from all children and adults in two Swiss tertiary centres whose respiratory samples were tested for respiratory viruses with a 16-plex rtPCR test.

RESULTS
Pathogens were identified in 140 of 254 patients (55%); of those patients, there was ≥1 virus in 91 (65%), ≥ 1 bacterium in 53 (38%), and ≥1 virus and bacterium in 11 (8%). Of 80 patients with viral infection, 59 (74%) received antibiotics. Virus detection was associated with discontinuation of antibiotics in 2 of 20 adults (10%) and 6 of 14 children (43%). Overall 12 adults (34%) and 18 children (67%) were managed correctly without antibiotics after virus detection (p = 0.01). When taking biomarkers, radiologic presentations, and antibiotic pre-treatment into account, the impact of rtPCR and appropriateness of therapy for clinically viral infections increased to 100% in children and 62% in adults.

CONCLUSIONS
A substantial reduction of unnecessary antibiotic prescriptions seems possible. Appropriate application of rtPCR results in respiratory tract infections should be encouraged.
   
citation Mayer L M, Kahlert C R, Rassouli F, Vernazza P, Albrich W. Impact of viral multiplex real-time PCR on management of respiratory tract infection: a retrospective cohort study. Pneumonia (Nathan) 2017; 9:4.
   
type journal paper/review (English)
date of publishing 25-02-2017
journal title Pneumonia (Nathan) (9)
ISSN print 2200-6133
pages 4
PubMed 28702306
DOI 10.1186/s41479-017-0028-z