MOLECULAR DIAGNOSTICS :: ANTIMICROBIAL RESISTANCE Another study5 was conducted with patients who were admit-
ted to the hospital with suspected pneumonia, had a clinical indication for bronchoscopy with bronchoalveolar lavage, and were at risk of Gram-negative bacterial infection. This study found that using a comprehensive multiplex molecular lower respiratory panel such as the Unyvero pneumonia test shortened inappropriate antibiotic therapy duration by 39 hours (p<0.0001), and reduced overall antibiotic therapy duration by 34 hours (22.5%). The multiplex panel also reduced the use of inappropri- ate antibiotic therapy by 45% (p<0.0001). In addition, patients tested with the molecular multiplex panel had a three-times higher probability of receiving appropriate antibiotic therapy.
Looking ahead
It is clear antimicrobial resistance in lower respiratory tract infections poses a significant threat to the global popula- tion. The global health community needs to continue embracing non-drug- based solutions in order to outpace growing AMR. Multiple studies have demonstrated the accuracy and impact of multiplex mo- lecular testing. As clinicians continue to grow in confidence around the validity of multiplex PCR panels, we can develop a clearer path forward in combatting anti- microbial resistance.
REFERENCES
1. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;12;399(10325):629- 655. doi: 10.1016/S0140-6736(21)02724-0.
2. COVID-19 reverses progress in fight against antimicrobial resistance in U.S. Centers for Dis- ease Control and Prevention. Published July 12, 2022. Accessed November 2, 2022. https://www.
cdc.gov/media/releases/2022/s0712-Antimicrobial- Resistance.html.
3. 2021 antibacterial agents in clinical and pre- clinical development: An overview and analysis. World Health Organization. Published May 27, 2022. Accessed November 2, 2022.
https://www.who.int/ publications/i/item/9789240047655.
4. GBD 2015 LRI Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infec- tions in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(11):1133-1161. doi: 10.1016/ S1473-3099(17)30396-1.
5. Santella B, Serretiello E, De Filippis A, et al. Lower respiratory tract pathogens and their anti- microbial susceptibility pattern: A 5-year study. Antibiotics (Basel). 2021;13;10(7):851. doi: 10.3390/ antibiotics10070851.
6. Fridkin S, Baggs J, Fagan R, et al. Vital signs: improving antibiotic use among hospital- ized patients. MMWR Morb Mortal Wkly Rep. 2014;63(9):194-200.
7. Ilges D, Ritchie DJ, Krekel T, et al. Assessment of antibiotic de-escalation by spectrum score in patients with nosocomial pneumonia: A single- center, retrospective cohort study. Open Forum Infect Dis. 2021;8(11):ofab508. doi: 10.1093/ofid/ ofab508.
DIAGNOSE WITH CONFIDENCE
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8. Vaughn VM, Flanders SA, Snyder A, et al. Excess antibiotic treatment dura- tion and adverse events in patients hospitalized with pneumonia: A multihospital cohort study. Ann Intern Med. 2019;171(3):153-163. doi:10.7326/M18-3640.
9. Tellapragada C, Ydsten KA, Ternhag A, Giske CG. Evaluation of a pneumonia multiplex PCR panel for detection of bacterial respiratory tract pathogens from serial specimens collected from hospitalized COVID-19 patients. Eur J Clin Microbiol Infect Dis. 2022;41(7):1093-1098. doi: 10.1007/s10096-022-04466-9.
Faranak Atrzadeh serves as Chief Marketing and Scientific Affairs Officer at OpGen Inc., a precision medicine company specializing in molecular diagnostics and bioinformatics to help combat infectious disease.
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