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Meningitis/Encephalitis diagnosis in ICU using Multiplex PCR system: Is it time of change?

López-Amor, L ; Escudero, D ; Fernández, J ; Martín-Iglesias, L ; Viña, L ; Fernández-Suárez, J ; Leal-Negredo, A ; Leoz, B ; Álvarez-García, L ; Castelló-Abietar, C ; Boga, J A ; Vázquez, F

Revista española de quimioterapia, 2019-06, Vol.32 (3), p.246-253

Spain

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Título:
Meningitis/Encephalitis diagnosis in ICU using Multiplex PCR system: Is it time of change?
Autor: López-Amor, L ; Escudero, D ; Fernández, J ; Martín-Iglesias, L ; Viña, L ; Fernández-Suárez, J ; Leal-Negredo, A ; Leoz, B ; Álvarez-García, L ; Castelló-Abietar, C ; Boga, J A ; Vázquez, F
Assuntos: Adult ; Aged ; Anti-Bacterial Agents - therapeutic use ; APACHE ; Encephalitis - cerebrospinal fluid ; Encephalitis - diagnosis ; Encephalitis - mortality ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Meningitis - cerebrospinal fluid ; Meningitis - diagnosis ; Meningitis - mortality ; Microbial Sensitivity Tests ; Middle Aged ; Multiplex Polymerase Chain Reaction - methods ; Prospective Studies ; Sensitivity and Specificity
É parte de: Revista española de quimioterapia, 2019-06, Vol.32 (3), p.246-253
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Undefined-1
ObjectType-Feature-3
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Descrição: To evaluate the clinical impact of Meningitis/Encephalitis FilmArray® panel for the diagnosis of cerebral nervous system infection and to compare the results (including time for diagnosis) with those obtained by conventional microbiological techniques. A prospective observational study in an Intensive Care Unit of adults from a tertiary hospital was carried out. Cerebrospinal fluid from all patients was taken by lumbar puncture and assessed by the meningitis/encephalitis FilmArray® panel ME, cytochemical study, Gram, and conventional microbiological cultures. A total of 21 patients admitted with suspicion of Meningitis/Encephalitis. Median age of patients was 58.4 years (RIQ 38.1-67.3), median APACHE II 18 (RIQ 12-24). Median stay in ICU and median hospital stay was 4 (RIQ 2-6) and 17 days (RIQ 14-28), respectively. The overall mortality was 14.3%. A final clinical diagnosis of meningitis or encephalitis was established in 16 patients, obtaining the etiological diagnosis in 12 of them (75%). The most frequent etiology was Streptococcus pneumoniae (8 cases). FilmArray® allowed etiological diagnosis in 3 cases in which the culture had been negative, and the results led to changes in the empirical antimicrobial therapy in 7 of 16 cases (43.8%). FilmArray® yielded a global sensitivity and specificity of 100% and 90%, respectively. The median time to obtain results from the latter and conventional culture (including antibiogram) was 2.9 hours (RIQ 2.1-3.8) and 45.1 hours (RIQ 38.9-58.7), respectively. The Meningitis/Encephalitis FilmArray® panel was able to establish the etiologic diagnosis faster than conventional methods. Also, it achieved a better sensitivity and led to prompt targeted antimicrobial therapy.
Editor: Spain
Idioma: Espanhol

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Meningitis/Encephalitis diagnosis in ICU using Multiplex PCR system: Is it time of change?

López-Amor, L ; Escudero, D ; Fernández, J ; Martín-Iglesias, L ; Viña, L ; Fernández-Suárez, J ; Leal-Negredo, A ; Leoz, B ; Álvarez-García, L ; Castelló-Abietar, C ; Boga, J A ; Vázquez, F

Spain

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