Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

Eur J Clin Microbiol Infect Dis. 2021 Oct;40(10):2227-2234. doi: 10.1007/s10096-021-04213-6. Epub 2021 Mar 17.

Abstract

Because the diagnosis of co/superinfection in COVID-19 patients is challenging, empirical antibiotic therapy is frequently initiated until microbiological analysis results. We evaluated the performance and the impact of the BioFire® FilmArray® Pneumonia plus Panel on 112 respiratory samples from 67 COVID-19 ICU patients suspected of co/superinfections. Globally, the sensitivity and specificity of the test were 89.3% and 99.1%, respectively. Positive tests led to antibiotic initiation or adaptation in 15% of episodes and de-escalation in 4%. When negative, 28% of episodes remained antibiotic-free (14% no initiation, 14% withdrawal). Rapid multiplex PCRs can help to improve antibiotic stewardship by administering appropriate antibiotics earlier and avoiding unnecessary prescriptions.

Keywords: Antibiotic stewardship; COVID-19; Coinfection; Multiplex PCR; Superinfection.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Antimicrobial Stewardship
  • Bacteria / classification
  • Bacteria / drug effects
  • Bacteria / genetics
  • Bacteria / isolation & purification*
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • COVID-19 / complications*
  • COVID-19 / virology
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Multiplex Polymerase Chain Reaction / methods*
  • Retrospective Studies
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / physiology

Substances

  • Anti-Bacterial Agents