Current Infectious Disease Reports最新文献_第10页

Racial/Ethnic Inequities in Healthcare-associated Infections Under the Shadow of Structural Racism: Narrative Review and Call to Action. 在结构性种族主义的阴影下，医疗保健相关感染中的种族/民族不平等:叙述审查和行动呼吁。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-08-27 DOI: 10.1007/s11908-021-00758-x

Jiabi Chen, Rohan Khazanchi, Gonzalo Bearman, Jasmine R Marcelin

{"title":"Racial/Ethnic Inequities in Healthcare-associated Infections Under the Shadow of Structural Racism: Narrative Review and Call to Action.","authors":"Jiabi Chen, Rohan Khazanchi, Gonzalo Bearman, Jasmine R Marcelin","doi":"10.1007/s11908-021-00758-x","DOIUrl":"https://doi.org/10.1007/s11908-021-00758-x","url":null,"abstract":"Purpose of review: The purpose of this study is to review racial and ethnic inequities in the incidence and prevention of healthcare-associated infections (HAIs) in the USA, identify gaps in the literature, and recommend future directions to mitigate these inequities.Recent findings: While some existing literature has identified the presence of racial/ethnic inequities in HAI incidence and outcomes, few studies to date have evaluated whether HAI prevention efforts have mitigated these inequities. Factors contributing to inequities in HAI prevention may include unconscious bias of healthcare professionals towards minoritized patients; socioeconomic and structural inequities disparately affecting minoritized communities; the racial segregation of quality healthcare through hospital price discrimination; divergent reimbursement rates between public and private insurers; policies or performance metrics which underfund and financially penalize safety-net hospitals; and insufficient research evaluating and addressing HAI inequities.Summary: Expansion of the literature is needed to further interrogate root causes and evaluate the impact of interventions on racial/ethnic inequities in HAI incidence. Measures to mitigate inequities might include teaching healthcare workers how to recognize and mitigate unconscious biases, expanding community resources which address the social and structural determinants of health, increasing access to preventive health services, reforming federal and institutional policies to better support safety-net hospitals and disincentivize price discrimination, and improving diversity and inclusion within the health workforce.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11908-021-00758-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39388320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Diagnostic Challenges in Sepsis. 败血症的诊断挑战。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-10-25 DOI: 10.1007/s11908-021-00765-y

Chris F Duncan, Taryn Youngstein, Marianne D Kirrane, Dagan O Lonsdale

{"title":"Diagnostic Challenges in Sepsis.","authors":"Chris F Duncan, Taryn Youngstein, Marianne D Kirrane, Dagan O Lonsdale","doi":"10.1007/s11908-021-00765-y","DOIUrl":"https://doi.org/10.1007/s11908-021-00765-y","url":null,"abstract":"Purpose of review: Sepsis is a leading cause of death worldwide. Groundbreaking international collaborative efforts have culminated in the widely accepted surviving sepsis guidelines, with iterative improvements in management strategies and definitions providing important advances in care for patients. Key to the diagnosis of sepsis is identification of infection, and whilst the diagnostic criteria for sepsis is now clear, the diagnosis of infection remains a challenge and there is often discordance between clinician assessments for infection.Recent findings: We review the utility of common biochemical, microbiological and radiological tools employed by clinicians to diagnose infection and explore the difficulty of making a diagnosis of infection in severe inflammatory states through illustrative case reports. Finally, we discuss some of the novel and emerging approaches in diagnosis of infection and sepsis.Summary: While prompt diagnosis and treatment of sepsis is essential to improve outcomes in sepsis, there remains no single tool to reliably identify or exclude infection. This contributes to unnecessary antimicrobial use that is harmful to individuals and populations. There is therefore a pressing need for novel solutions. Machine learning approaches using multiple diagnostic and clinical inputs may offer a potential solution but as yet these approaches remain experimental.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39578812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Infection Prevention and Antimicrobial Stewardship Program Collaboration During the COVID-19 Pandemic: a Window of Opportunity. COVID-19 大流行期间的感染预防和抗菌药物管理计划合作：机会之窗。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-08-18 DOI: 10.1007/s11908-021-00759-w

Mariam Assi, Salma Abbas, Priya Nori, Michelle Doll, Emily Godbout, Gonzalo Bearman, Michael P Stevens

{"title":"Infection Prevention and Antimicrobial Stewardship Program Collaboration During the COVID-19 Pandemic: a Window of Opportunity.","authors":"Mariam Assi, Salma Abbas, Priya Nori, Michelle Doll, Emily Godbout, Gonzalo Bearman, Michael P Stevens","doi":"10.1007/s11908-021-00759-w","DOIUrl":"10.1007/s11908-021-00759-w","url":null,"abstract":"Purpose of review: We describe the similarities between antimicrobial stewardship programs (ASPs) and infection prevention programs (IPPs), and we discuss how these similarities lend themselves to synergy between programs. We also discuss how the COVID-19 pandemic has generated further opportunities for future collaborations that could benefit both programs.Recent findings: The COVID-19 pandemic has created new needs, such as real-time data and access to personnel important to both programs, such as information technologists and infectious diseases specialists. It has also increased concerns about rising rates of antimicrobial resistance and healthcare-associated infections, both of which overlap significantly and are key focus areas for both ASPs and IPPs. These emergent issues have highlighted the need for enhanced program infrastructure and new team models. The shift towards telecommunication and telework has facilitated the creation of enhanced infrastructures for collaboration on activities ranging from data access and reporting to providing telehealth services to remote hospitals. These enhanced infrastructures can be leveraged in future collaborative efforts between ASPs and IPPs.Summary: Collaboration between IPPs and ASPs can mitigate setbacks experienced by health systems during the current pandemic, enhance the performance of both programs in the post-pandemic era and increase their preparedness for future pandemic threats. As health systems plan for the post-pandemic era, they should invest in opportunities for synergy between ASPs and IPPs highlighted during the pandemic.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39338892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What Is the Impact of Lockdowns on Dengue? 封锁对登革热有什么影响?

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 DOI: 10.1007/s11908-020-00744-9

Oliver Brady, Annelies Wilder-Smith

{"title":"What Is the Impact of Lockdowns on Dengue?","authors":"Oliver Brady, Annelies Wilder-Smith","doi":"10.1007/s11908-020-00744-9","DOIUrl":"https://doi.org/10.1007/s11908-020-00744-9","url":null,"abstract":"Purpose of review: Societal lockdowns in response to the COVID-19 pandemic have led to unprecedented disruption to daily life across the globe. A collateral effect of these lockdowns may be a change to transmission dynamics of a wide range of infectious diseases that are all highly dependent on rates of contact between humans. With timing, duration and intensity of lockdowns varying country-to-country, the wave of lockdowns in 2020 present a unique opportunity to observe how changes in human contact rates, disease control and surveillance affect dengue virus transmission in a global natural experiment. We explore the theoretical basis for the impact of lockdowns on dengue transmission and surveillance then summarise the current evidence base from country reports.Recent findings: We find considerable variation in the intensity of dengue epidemics reported so far in 2020 with some countries experiencing historic low levels of transmission while others are seeing record outbreaks. Despite many studies warning of the risks of lockdown for dengue transmission, few empirically quantify the impact and issues such as the specific timing of the lockdowns and multi-annual cycles of dengue are not accounted for. In the few studies where such issues have been accounted for, the impact of lockdowns on dengue appears to be limited.Summary: Studying the impact of lockdowns on dengue transmission is important both in how we deal with the immediate COVID-19 and dengue crisis, but also over the coming years in the post-pandemic recovery period. It is clear lockdowns have had very different impacts in different settings. Further analyses might ultimately allow this unique natural experiment to provide insights into how to better control dengue that will ultimately lead to better long-term control.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11908-020-00744-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9301684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 36

Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days. 通过减少中心静脉注射天数减少中心静脉相关血流感染(CLABSIs)。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-11-02 DOI: 10.1007/s11908-021-00767-w

Amber Shaye McElveen Beville, Diane Heipel, Ginger Vanhoozer, Pamela Bailey

{"title":"Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days.","authors":"Amber Shaye McElveen Beville, Diane Heipel, Ginger Vanhoozer, Pamela Bailey","doi":"10.1007/s11908-021-00767-w","DOIUrl":"https://doi.org/10.1007/s11908-021-00767-w","url":null,"abstract":"Purpose of review: While reducing unnecessary days present of central venous catheters (CVCs) is part of central line associated bloodstream infection (CLABSI) best practices, there is limited information regarding compliance with this recommendation as well as addressing barriers to compliance.Recent findings: Significant work has been directed towards daily audits of necessity and improving communication between members of the medical team. Other critical interventions include utilization of the electronic health record (EHR), leadership support of CLABSI reduction goals, and avoiding CVC placement over more appropriate vascular access.Summary: Institutions have varied approaches to addressing the issue of removing idle CVCs, and more standardized approaches in checklists as well as communication, particularly on multidisciplinary rounds, will be key to CVC removal. Utilization of the EHR for reminders or appropriate documentation of necessity is a factor. Avoidance of placing a CVC or appropriateness of the CVC is also important to consider.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8562022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39596549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Therapeutic Options for Coronavirus Disease 2019 (COVID-19): Where Are We Now? 2019冠状病毒病（新冠肺炎）的治疗选择：我们现在在哪里？

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-12-11 DOI: 10.1007/s11908-021-00769-8

Esther Y Golnabi, James M Sanders, Meagan L Johns, Kevin Lin, Jessica K Ortwine, Wenjing Wei, Norman S Mang, James B Cutrell

{"title":"Therapeutic Options for Coronavirus Disease 2019 (COVID-19): Where Are We Now?","authors":"Esther Y Golnabi, James M Sanders, Meagan L Johns, Kevin Lin, Jessica K Ortwine, Wenjing Wei, Norman S Mang, James B Cutrell","doi":"10.1007/s11908-021-00769-8","DOIUrl":"10.1007/s11908-021-00769-8","url":null,"abstract":"Purpose of review: Rapidly evolving treatment paradigms of coronavirus disease 2019 (COVID-19) introduce challenges for clinicians to keep up with the pace of published literature and to critically appraise the voluminous data produced. This review summarizes the clinical evidence from key studies examining the place of therapy of recommended drugs and management strategies for COVID-19.Recent findings: The global magnitude and duration of the pandemic have resulted in a flurry of interventional treatment trials evaluating both novel and repurposed drugs targeting various aspects of the viral life cycle. Additionally, clinical observations have documented various stages or phases of COVID-19 and underscored the importance of timing for the efficacy of studied therapies. Since the start of the COVID-19 pandemic, many observational, retrospective, and randomized controlled studies have been conducted to guide management of COVID-19 using drug therapies and other management strategies. Large, randomized, or adaptive platform trials have proven the most informative to guide recommended treatments to-date. Antimicrobial stewardship programs can play a pivotal role in ensuring appropriate use of COVID-19 therapies based on evolving clinical data and limiting unnecessary antibiotics given low rates of co-infection.Summary: Given the rapidly evolving medical literature and treatment paradigms, it is recommended to reference continuously updated, curated guidelines from national and international sources. While the drugs and management strategies mentioned in this review represent the current state of recommendations, many therapies are still under investigation to further define optimal COVID-19 treatment.Supplementary information: The online version contains supplementary material available at 10.1007/s11908-021-00769-8.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39738475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evidence Regarding Rapid Initiation of Antiretroviral Therapy in Patients Living with HIV. 关于艾滋病病毒感染者快速启动抗逆转录病毒疗法的证据。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-04-02 DOI: 10.1007/s11908-021-00750-5

Sarah M Michienzi, Mario Barrios, Melissa E Badowski

{"title":"Evidence Regarding Rapid Initiation of Antiretroviral Therapy in Patients Living with HIV.","authors":"Sarah M Michienzi, Mario Barrios, Melissa E Badowski","doi":"10.1007/s11908-021-00750-5","DOIUrl":"10.1007/s11908-021-00750-5","url":null,"abstract":"Purpose of review: Rapid initiation of antiretroviral therapy (ART) is increasingly more common among clinics serving people living with human immunodeficiency virus (PLWH). It is recommended by major guidelines and is especially important in achieving the Getting to Zero (GTZ) goals by 2030. Patients should be offered the option to initiate ART as soon as possible, preferably at time of HIV diagnosis, with the goal of reducing transmission, morbidity, and mortality.Recent findings: Three published randomized controlled trials, and several other observational, prospective, and retrospective studies, demonstrated superior rates of viral suppression (VS) with initiation of rapid ART compared to standard of care. Improved time to VS and retention in care were also observed. Based on the regimens studied, a tenofovir backbone combined with an integrase strand transfer inhibitor or protease inhibitor is recommended for rapid start initiation. Since ART is started earlier compared with standard of care, there is opportunity to achieve VS at a much faster rate, especially in the setting of starting on the day of diagnosis. What requires further evaluation is whether or not VS is sustained over time with quicker linkage and initiation of HIV care.Summary: Initiating rapid ART in newly diagnosed PLWH provides a promising approach to achieving GTZ. When offered rapid ART, virologic suppression is improved compared to standard of care, which may reduce transmission and, ultimately, new HIV infections.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25565714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Host Diagnostic Biomarkers of Infection in the ICU: Where Are We and Where Are We Going? ICU感染的宿主诊断生物标志物:我们在哪里，我们要去哪里?

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-02-12 DOI: 10.1007/s11908-021-00747-0

Aaron J Heffernan, Kerina J Denny

{"title":"Host Diagnostic Biomarkers of Infection in the ICU: Where Are We and Where Are We Going?","authors":"Aaron J Heffernan, Kerina J Denny","doi":"10.1007/s11908-021-00747-0","DOIUrl":"https://doi.org/10.1007/s11908-021-00747-0","url":null,"abstract":"Purpose of review: Early identification of infection in the critically ill patient and initiation of appropriate treatment is key to reducing morbidity and mortality. On the other hand, the indiscriminate use of antimicrobials leads to harms, many of which may be exaggerated in the critically ill population. The current method of diagnosing infection in the intensive care unit relies heavily on clinical gestalt; however, this approach is plagued by biases. Therefore, a reliable, independent biomarker holds promise in the accurate determination of infection. We discuss currently used host biomarkers used in the intensive care unit and review new and emerging approaches to biomarker discovery.Recent findings: White cell count (including total white cell count, left shift, and the neutrophil-leucocyte ratio), C-reactive protein, and procalcitonin are the most common host diagnostic biomarkers for sepsis used in current clinical practice. However, their utility in the initial diagnosis of infection, and their role in the subsequent decision to commence treatment, remains limited. Novel approaches to biomarker discovery that are currently being investigated include combination biomarkers, host 'sepsis signatures' based on differential gene expression, site-specific biomarkers, biomechanical assays, and incorporation of new and pre-existing host biomarkers into machine learning algorithms.Summary: To date, no single reliable independent biomarker of infection exists. Whilst new approaches to biomarker discovery hold promise, their clinical utility may be limited if previous mistakes that have afflicted sepsis biomarker research continue to be repeated.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11908-021-00747-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25395062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Pediatric Infectious Diseases Encountered During Wartime-Part 1: Experiences and Lessons Learned From Armed Conflict in the Modern Era. 战时遇到的小儿传染病--第一部分：现代武装冲突的经验和教训。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-12-09 DOI: 10.1007/s11908-021-00770-1

Martin Ottolini, Blake Cirks, Kathleen B Madden, Michael Rajnik

{"title":"Pediatric Infectious Diseases Encountered During Wartime-Part 1: Experiences and Lessons Learned From Armed Conflict in the Modern Era.","authors":"Martin Ottolini, Blake Cirks, Kathleen B Madden, Michael Rajnik","doi":"10.1007/s11908-021-00770-1","DOIUrl":"10.1007/s11908-021-00770-1","url":null,"abstract":"Purpose of review: Armed conflicts occur globally, with some regions experiencing heightened instability for many years. A better understanding of the infectious disease impact on children in armed conflict will allow aid organizations to anticipate and mitigate the most serious problems.Recent findings: Armed conflicts are estimated to have caused approximately 30 million civilian deaths during the past 27 years, with two-thirds occurring in women and children. Children are extremely vulnerable to the mass population displacements, experiencing a combined loss of safety, nutrition, shelter, hygiene, and health care. Under these circumstances, the emergence and prevalence of multiple infectious diseases can result in heightened morbidity and mortality long after active conflict ceases.Summary: Factors leading to increased infectious diseases in populations in crisis due to armed conflict and lessons learned from recent outbreaks are discussed in detail. Acute respiratory infections, diphtheria, measles, varicella, and cholera are a few of the more common infectious diseases that take advantage of populations displaced or disrupted by conflict. Key issues include the ability of countries or non-governmental organizations (NGOs) to keep up with basic childhood immunizations, and how rapidly disease outbreaks are recognized and addressed with disease-specific interventions.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39585268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions. 综合多重聚合酶链反应（mPCR）检测与抗菌药物管理：当前实践与未来方向》。

IF 3.1 4区医学

Current Infectious Disease Reports Pub Date : 2021-01-01 Epub Date: 2021-02-26 DOI: 10.1007/s11908-021-00748-z

Theodore S Rader, Michael P Stevens, Gonzalo Bearman

{"title":"Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions.","authors":"Theodore S Rader, Michael P Stevens, Gonzalo Bearman","doi":"10.1007/s11908-021-00748-z","DOIUrl":"10.1007/s11908-021-00748-z","url":null,"abstract":"Purpose of review: Syndromic multiplex polymerase chain reaction (mPCR) panels offer the antimicrobial steward a rapid tool for optimizing and de-escalating antimicrobials. In this review, we analyze the role of syndromic mPCR in respiratory, gastrointestinal, and central nervous system infections within the context of antimicrobial stewardship efforts.Recent findings: For all mPCR syndromic panels, multiple studies analyzed the pre-and-post implementation impact of mPCR on antimicrobial utilization. Prospective studies and trials of respiratory mPCR stewardship interventions, including diagnostic algorithms, educational efforts, co-testing with procalcitonin, and targeted provider feedback currently exist. For gastrointestinal and cerebrospinal fluid mPCR, fewer peer-reviewed reports exist for the use of mPCR in antimicrobial stewardship. These studies demonstrated an inconsistent trend towards decreasing antibiotic use with mPCR. This is further limited by a lack of statistical significance, the absence of controlled, prospective trials, and issues with data generalizability.Summary: Antibiotic overuse may improve when mPCR is coupled with electronic medical record algorithm-based approaches and direct provider feedback by an antimicrobial stewardship professional. mPCR may prove a useful tool for antimicrobial stewardship but future studies are needed to define the best practice for its utilization.","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25444347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0