Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. Albrich W.C., Madhi S.A., Adrian P.V., Telles J.-N., Parankos-Baccala G., Klugman K.P. Genomic load from sputum samples and nasaopharyngeal swabs for diagnosis of pneumococcal pneumonia in HIV-infected adults. J Clin Microbiol. 2014;52:4224–4229. - PMC - PubMed
    1. Andrews A.L., Simpson A.N., Heine D., Teufel R.J. A cost-effectiveness analysis of obtaining blood cultures in children hospitalized for community-acquired pneumonia. J Pediatrics. 2015;167:1280–1286. - PubMed
    1. Becker K.L., Snider R., Nylen E.S. Procalcitonin assay in systemic inflammation, infection and sepsis: clinical utility and limitatons. Crit Care Med. 2008;36:941–952. - PubMed
    1. Branche A.R., Walsh E.E., Vargas R., Hulbert B., Formica M.A., Baran A. Serum procalcitonin and viral testing to guide antibiotic use for respiratory infections in hospitalized adults: a randomized controlled trial. J Infect Dis. 2015;212:1692–1700. - PMC - PubMed
    1. Collins A.M., Johnstone C.M.K., Gritzfeld J.F., Banyard A., Hancock C.A. wright AD et al. Pneumococcal colonization rates in patients admitted to a United kingdom Hospital with Lower Respiratory Tract Infection: a Prospective Case-Control study. J. Clinical Microbiology. 2016;54:944–949. - PMC - PubMed

MeSH terms