在儿童骨关节和胸膜间隙感染中直接鉴定病原体和抗菌药物耐药性标志物的综合征面板的临床表现。

IF 5.4 2区 医学 Q1 MICROBIOLOGY
B C Sanchez, H Sayeed, D T Niles, J J Dunn
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引用次数: 0

摘要

从儿童无菌体液中回收微生物病原体带来了挑战,包括传统培养的低灵敏度。使用经验性抗菌素进行预处理可使病原体无法存活。在这种情况下,对于像Kingella kingae这样挑剔的生物,分子方法对于鉴定病原体是有用的。本研究评估了biomrieux BIOFIRE关节感染(JI)小组与标准护理(SOC)诊断技术在儿童骨关节、胸膜液和脓肿标本中的临床表现。共有136个标本(77个关节标本和59个胸膜标本)通过JI小组进行了测试。SOC方法包括实验室开发的实时PCR (Laboratory-developed PCR [LDT-PCR])、常规培养和辅助检测。与复合SOC方法相比,JI Panel对骨关节标本板上生物的检测阳性率(PPA)为90.1%,阴性阳性率(NPA)为99.9%。对于胸膜标本,JI组的PPA为93.8%,NPA为99.6%。LDT-PCR在两种标本中均检测到假阴性,周期阈值≥35,这可能表明这些标本中的微生物负担较低。JI小组在骨关节标本中检测金氏k菌(PPA = 93.8%)和胸膜标本中检测肺炎链球菌(PPA = 95.2%)方面表现良好,这是在这些标本类型中发现的最常见的儿科病原体。JI小组有可能影响儿科患者的治疗和管理,特别是在培养阴性病例中。重要性:鉴定儿童骨关节和胸膜间隙感染的病原体是具有挑战性的,因为常规细菌培养通常没有生长。BIOFIRE联合感染小组是一种快速、多重PCR检测,可检测广泛的微生物和抗微生物耐药性基因。本研究表明,该小组与检测常见儿科病原体的标准护理方法有很好的一致性,并可能有助于快速诊断儿童骨关节和胸膜间隙感染。然而,由于可能出现假阴性和假阳性结果,建议将该检测与标准细菌培养和临床表现背景下的结果解释结合使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
 Clinical performance of a syndromic panel for direct identification of pathogens and antimicrobial resistance markers in pediatric osteoarticular and pleural space infections.

The recovery of microbial pathogens from sterile body fluids in children poses challenges, including the low sensitivity of conventional culture. Pre-treatment with empiric antimicrobials can render the pathogen non-viable. In such cases, and with fastidious organisms like Kingella kingae, molecular methods are useful for identification of the causative agent. This study evaluated the clinical performance of the bioMérieux BIOFIRE Joint Infection (JI) Panel to standard-of-care (SOC) diagnostic techniques in pediatric osteoarticular and pleural fluid and abscess specimens. A total of 136 specimens (77 joint and 59 pleural), were tested with the JI Panel. SOC methods included a lab-developed, real-time PCR assay (Laboratory-developed PCR [LDT-PCR]), routine culture and ancillary testing. Compared to the composite SOC methods, the JI Panel had a positive percent agreement (PPA) of 90.1% and negative percent agreement (NPA) of 99.9% for the detection of on-panel organisms in osteoarticular specimens. For pleural specimens, the JI Panel had a PPA of 93.8% and NPA of 99.6%. False negatives by the JI Panel in both specimen types were detected by the LDT-PCR with cycle thresholds ≥35, which may suggest a low burden of microorganisms in these specimens. The JI Panel demonstrated good performance for the detection of K. kingae (PPA = 93.8%) in osteoarticular specimens and Streptococcus pneumoniae (PPA = 95.2%) in pleural specimens, the most common pediatric pathogens identified in these respective specimen types. The JI Panel has the potential to impact the treatment and management of pediatric patients, especially in culture-negative cases.

Importance: The identification of the causative agents of osteoarticular and pleural space infections in children is challenging, as routine bacterial cultures often yield no growth. The BIOFIRE Joint Infection Panel is a rapid, multiplex PCR assay that detects a wide range of microorganisms and antimicrobial resistance genes. This study demonstrates that the panel has good agreement with standard of care methods for the detection of common pediatric pathogens and may aid in the rapid diagnosis of osteoarticular and pleural space infections in children. However, it is recommended that the assay be used in conjunction with standard bacterial cultures and results interpreted within the context of the clinical presentation, since false-negative and false-positive results may occur.

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来源期刊
Journal of Clinical Microbiology
Journal of Clinical Microbiology 医学-微生物学
CiteScore
17.10
自引率
4.30%
发文量
347
审稿时长
3 months
期刊介绍: The Journal of Clinical Microbiology® disseminates the latest research concerning the laboratory diagnosis of human and animal infections, along with the laboratory's role in epidemiology and the management of infectious diseases.
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