Cited by Diagnosis and treatment of infection specific to the perinatal period (Draft clinical recommendations for discussion by neonatologists and pediatricians)

Seven-year performance of a clinical metagenomic next-generation sequencing test for diagnosis of central nervous system infections DOI

Patrick Benoit, Noah Brazer, Mikaël de Lorenzi-Tognon

et al.

Nature Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 12, 2024

Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) is an agnostic method for broad-based diagnosis central nervous system (CNS) infections. Here we analyzed the 7-year performance clinical CSF mNGS testing 4,828 samples from June 2016 to April 2023 performed by University California, San Francisco (UCSF) microbiology laboratory. Overall, detected 797 organisms 697 (14.4%) samples, consisting 363 (45.5%) DNA viruses, 211 (26.4%) RNA 132 (16.6%) bacteria, 68 (8.5%) fungi and 23 (2.9%) parasites. We also extracted laboratory metadata a subset (n = 1,164) 1,053 UCSF patients. Among 220 infectious diagnoses in this subset, 48 (21.8%) were identified alone. The sensitivity, specificity accuracy CNS infections 63.1%, 99.6% 92.9%, respectively. exhibited higher sensitivity (63.1%) than indirect serologic (28.8%) direct detection both (45.9%) non-CSF (15.0%) (P < 0.001 all three comparisons). When only considering made testing, increased 86%. These results justify routine use diagnostic hospitalized patients with suspected infection.

Language: Английский

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The elusive concept of appropriate antibiotic for septic patients when a pathogen is not detected by standard culture methods DOI

Alberto Enrico Maraolo, Rita Murri, Danilo Buonsenso

et al.

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Jan. 6, 2025

Language: Английский

Citations

Novel technologies for the diagnosis of urinary tract infections DOI

Tomas A. Bermudez, Jonathan E. Schmitz,

Malcolm Boswell

et al.

Journal of Clinical Microbiology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 6, 2025

ABSTRACT Urinary tract infections (UTIs) impose a substantial burden on patient quality of life and urine testing accounts for the majority workload in many clinical microbiology laboratories. Traditional UTI diagnosis relies symptoms, urinalysis, culture which are interpreted based historical guidelines. This approach, while foundational, presents limitations, particularly complex cases. Low-level bacteriuria presence fastidious organisms often overlooked or entirely missed standard culture, stressing need novel diagnostic methods technologies. mini-review summarizes existing state diagnostics 2024 covers current upcoming technologies including rapid molecular-based pathogen identification, next-generation sequencing, advanced antimicrobial susceptibility testing. However, these represent unique challenges, as they implemented, will require field to adapt new concepts avoid misdiagnosis overtreatment.

Language: Английский

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Improving UTI Diagnostics in Oncology: Reliability of Reflex Urine Culture in Immunosuppressed Neutropenic and Non-neutropenic Cancer Patients DOI

Justin Laracy, June L. Chan, Rich Kodama

et al.

Clinical Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 15, 2025

Urinary tract infections are prone to overdiagnosis, and reflex urine culture protocols offer a valuable opportunity for diagnostic stewardship in this arena. However, there is no recommended standard testing approach. Cancer patients often excluded from protocols, especially if severely immunosuppressed or neutropenic. The aim of study was evaluate the performance characteristics screening studies, including dipstick urinalysis nitrite leukocyte esterase microscopy white blood cell count, detect significant pathogen growth. A retrospective 58,098 cultures with paired without performed at Memorial Sloan Kettering Center New York City, evaluating data January 1, 2018, December 31, 2020. considered negative only were undetected. had predictive value (NPV) 98% clinically bacteriuria voided urine, 95% catheterized urine. Notably, test screen maintained high NPV among neutropenia those antibiotic exposure before testing. Finally, presence pyuria ≥10 cells per power field on offered negligible incremental benefit samples urinalysis. Reflex contingent upon safe effective platform cancer neutropenia.

Language: Английский

Citations

Periprosthetic Joint Infection DOI

Hussam Tabaja, Omar Abu Saleh, Douglas R. Osmon

et al.

Infectious Disease Clinics of North America, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 1, 2024

Language: Английский

Citations

Blood Culture Contamination and Diagnostic Stewardship: From a Clinical Laboratory Quality Monitor to a National Patient Safety Measure DOI

Jake D Bunn, Nancy E. Cornish

The Journal of Applied Laboratory Medicine, Journal Year: 2025, Volume and Issue: 10(1), P. 162 - 170

Published: Jan. 1, 2025

Abstract Laboratory analysis of blood cultures is vital to the accurate and timely diagnosis bloodstream infections. However, reliability test depends on clinical compliance with standard operating procedures that limit risk inconclusive or incorrect results. False-negative culture results due inadequate volumes can result in misdiagnosis, delay therapy, increase patients’ developing dying from Likewise, commonly occurring bacteria fungi human skin (i.e., commensal organisms) contaminate during collection false positives, compromising care leading unnecessary antibiotic therapy prolonged hospitalization. In December 2022, a Centers for Medicare & Medicaid Services (CMS) consensus-based entity (CBE) endorsed Disease Control Prevention’s (CDC) proposal new patient safety measure address these concerns. CDC developed this quality promote standardization best practices improve laboratory infections nationally. This special report will emphasize importance standardizing describe need national measure, tools, next steps.

Language: Английский

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Blood Culture Use in Medical and Surgical Intensive Care Units and Wards DOI

Valeria Fabre, Yea‐Jen Hsu, Karen C. Carroll

et al.

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2454738 - e2454738

Published: Jan. 15, 2025

Importance Blood culture (BC) use benchmarks in US hospitals have not been defined. Objective To characterize BC adult intensive care units (ICUs) and wards hospitals. Design, Setting, Participants A retrospective cross-sectional study of medical ICUs, medical-surgical wards, from acute the 4 geographic regions was conducted. Critical access hospitals, less than 6 months data, non-US were excluded. The included data September 1, 2019, to August 31, 2021. Data analyzed February 23 July 14, 2024. Main Outcomes Measures primary outcome per 1000 patient-days. Adjusted means with 95% CIs calculated using mixed-effects negative binomial regression models adjusted for unit type, hospital bed size, region, seasonality, state COVID-19 case load, random intercepts accounting clustering at levels. Secondary outcomes blood positivity, single BCs, contamination, minimum threshold where positivity would be optimized. Results total 362 327 cultures 27 35 121 109 48 19 states District Columbia. mean patient-days 273.1 (95% CI, 270.2-275.9) 146.0 144.5-147.5) 80.3 79.8-80.7) 65.1 wards. significantly higher across all types more 500 beds compared or West-Midwest other regions. Single positive rates below 10% types. Of 292 units, 97% had a contamination rate within 3% recommended threshold, 51% 1%. thresholds (ie, this number may represent undertesting) 120 BCs 80 30 Conclusions Relevance findings suggest that help determine appropriate individual

Language: Английский

Citations

Comparing sputum, nasopharyngeal swabs, and combined samples for respiratory bacterial detection using multiplex PCR DOI

Keun Ju Kim, Seung Gyu Yun, Myung‐Hyun Nam

et al.

Microbiology Spectrum, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 30, 2025

ABSTRACT Respiratory tract infections are major global health issues that require rapid and accurate diagnostic methods. Multiplex quantitative PCR (qPCR) is commonly used for pathogen detection in respiratory samples. However, the optimal specimen selection detecting bacterial pathogens not well-explored. We evaluated rates of bacteria from nasopharyngeal swabs (NPS), sputum, combined NPS sputum samples using multiplex qPCR (Allplex PneumoBacter Assay, Seegene). Paired 219 patients with acute symptoms admitted to Korea University Anam Hospital were analyzed. was performed detect seven bacteria: Bordetella parapertussis, pertussis, Chlamydophila pneumoniae, Haemophilus influenzae, Legionella pneumophila, Mycoplasma Streptococcus pneumoniae . Combined ( n = 92) created 46 pairs positive negative signals NPS-alone sputum-alone Sputum (44.3%; 97/219) had a significantly higher positivity rate compared (21.0%; 46/219) P < 0.001). The 92 identified total 65 nucleic acids. 86.2% (56/65), which comparable alone (89.2%; 58/65) than (50.8%; 33/65). Combining testing may offer an alternative detection, providing those greater sensitivity alone. This approach could be cost-effective method maximize yield, reduce need multiple tests, improve management infections. IMPORTANCE study offers important insights into refining strategies PCR. finds combining single tube serve as effective adults illness.

Language: Английский

Citations

Diagnosis of Coxiella burnetii endocarditis by using nanopore targeted sequencing: a case report DOI

Xinsheng Yan,

Qimei Wei,

Tingting Liu

et al.

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 5, 2025

Language: Английский

Citations

Real World Evaluation of Next-Day Molecular Respiratory Infectious Disease Testing on Healthcare Resource Utilization and Costs DOI

Andrea French, Maren S. Fragala, Azia S. Evans

et al.

ClinicoEconomics and Outcomes Research, Journal Year: 2025, Volume and Issue: Volume 17, P. 79 - 93

Published: Feb. 1, 2025

Purpose: Advancements in pathogen identification by diagnostic testing may improve patient outcomes. This study evaluated healthcare utilization and costs following for acute oropharyngeal respiratory tract infections (RTIs). Patients Methods: Healthcare were patients with (n=1,172,693), RTIs (n=4,005,228) who received a syndromic panel-based PCR test next-day results (HealthTrackRx, Denton, TX), or no the IQVIA PharMetrics ® Plus adjudicated claims database. Results: Statistically significant differences observed between compared to those test. The cohort had lower total (mean = $5,601±$29,170, median $807) versus $7,460±$40,817, $1,163) (p 0.0014) over 6 months, fewer outpatient visits, other medical service emergency room inpatient stays (p< 0.0001). Similarly, infection trended towards $4,393±$13,524, median=$844) than $5,503±$34,141, $956) (p=0.0525) services Conclusion: Next-day molecular lowers costs, suggesting improved care through reduced need resources. Keywords: PCR, NAAT, multiplex testing, virus, influenza viruses, infection, pharyngitis, diagnostics,

Language: Английский

Citations