2024-08-27 08:45:17
Pneumonia is a disease caused by infection with bacteria or respiratory viruses, mainly pneumococcus and influenza virus. Inflammation and the appearance of pus and fluid in the lung alveoli make breathing difficult and, if the problem is not treated properly, it can lead to death. In the case of community-acquired pneumonia (acquired outside the hospital) the incidence is very high. In the case of Europe it is 2 to 10 cases per 1,000 inhabitants per year. Almost half of the patients will need to be admitted to the hospital and 5% to the ICU (Intensive Care Unit), making this infection one of the main reasons for the use of antibiotics in hospitals and, as a result, the effectiveness of the antibiotic is significant. resistance
Infections due to resistant bacteria and associated deaths increase year after year, making antibiotic resistance one of the main current health challenges. Therefore, it is important to use these drugs only in case of bacterial infection and choose the most appropriate one after correctly identifying the pathogen that causes it. Currently, microbiological tests such as Gram stain, sputum culture, blood cultures or the presence of antigens in the urine are used to identify the etiological agent of pneumonia, but in more than half of the cases the results are negative. With the development of multiplex PCR on automated platforms, it is interesting to evaluate whether its implementation in clinical practice can be useful to explain the use of antibiotics in pneumonia and improve patient outcomes.
Now, a research group has conducted a randomized study to evaluate whether this research tool can reduce the days of antibiotic treatment.
The team is made up of Jordi Carratalà, Gabriela Abelenda-Alonso and other specialists, from the Bellvitge University Hospital (HUB) at the Hospitalet de Llobregat, Barcelona, Bellvitge Biomedical Research Center (IDIBELL), who is at the Hospitalet de Llobregat and which belongs to the CERCA institutions of the Generalitat of Catalonia, and the Networked Biomedical Research Center for Infectious Diseases (CIBERINFEC), in Spain.
The research team has evaluated the use of multiplex quantitative PCR in pneumonia to optimize the use of antibiotics. (Photo: IDIBELL)
Community-acquired pneumonia patients at Bellvitge Hospital were randomly selected to undergo multiplex PCR on non-invasive respiratory samples, in addition to routine microbiological testing, or routine testing alone.
Judging by the results, the use of PCR did not lead to a significant reduction in treatment days, although it increased the etiological diagnoses and reduced the time needed to achieve them. In addition, the time to conversion from intravenous to oral treatment was reduced, but no difference was observed in adverse effects or 30-day mortality.
According to Dr. Carratalà, the coordinator of the study, “the findings do not support the regular implementation of the use of multiplex PCR in the management of all patients who are hospitalized with community-acquired pneumonia,” and concluded that “the new research that has been assigned. Educational processes are important.” on the interpretation of PCR results and their use to inform the use of antibiotics.
The study is titled “Multiplex real-time PCR in non-lethal respiratory samples to reduce antibiotic use in community-acquired pneumonia: a randomized trial.” And it was published in the academic journal Nature Communications. (Source: IDIBELL)
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