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Comparative Study
. 2016 Sep;86(1):102-7.
doi: 10.1016/j.diagmicrobio.2016.06.008. Epub 2016 Jun 15.

The potential of molecular diagnostics and serum procalcitonin levels to change the antibiotic management of community-acquired pneumonia

David Gilbert  1 , Gita Gelfer  2 , Lian Wang  2 , Jillian Myers  2 , Kristina Bajema  2 , Michael Johnston  2 , James Leggett  2
Affiliations
Comparative Study

The potential of molecular diagnostics and serum procalcitonin levels to change the antibiotic management of community-acquired pneumonia

David Gilbert et al. Diagn Microbiol Infect Dis. 2016 Sep.

Abstract

Two diagnostic bundles were compared in 127 evaluable patients admitted with community-acquired pneumonia (CAP). Diagnostic modalities in all patients included cultures of sputum (if obtainable) and blood, urine for detection of the antigens of Streptococcus pneumoniae and Legionella pneumophila, and nasal swabs for PCR probes for S. pneumoniae and Staphylococcus aureus. At least one procalcitonin level was measured in all patients. For virus detection, patients were randomized to either a 5-virus, lab-generated PCR panel or the broader and faster FilmArray PCR panel. Overall, an etiologic diagnosis was established in 71% of the patients. A respiratory virus was detected in 39%. The potential for improved antibiotic stewardship was evident in 25 patients with only detectable respiratory virus and normal levels of PCT.

Keywords: Community-acquired pneumonia; Diagnostic bundles; FilmArray; Molecular diagnostics; Procalcitonin.

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Figures

Fig. 1
Fig. 1
Screening, eligibility, and enrollment of hospitalized adults with CAP.
Fig. 2
Fig. 2
Box plot of PCT values in patients with CAP caused by a virus, bacteria, or a combination of a virus and bacteria. The PCT values in patients with CAP due to bacteria alone or a virus plus bacteria are significantly higher than in patients with CAP caused only by a virus, P = 0.003.
See this image and copyright information in PMC

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