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Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis / Santiago León Atehortúa Muñoz    

Público ISBD Título : Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis Tipo de documento : documento electrónico Autores : Santiago León Atehortúa Muñoz, Fecha de publicación : 2022 Títulos uniformes : eClinicalMedicine Idioma : Inglés (eng) Palabras clave : CNS infection  Diagnostic accuracy  Encephalitis  Film array  Meningitis  Meta-analysis  Multiplex PCR Resumen : Background: The FilmArray Meningitis/Encephalitis(FA/ME) panel brings benefits in clinical practice, but its diagnostic test accuracy (DTA) remains unclear. We aimed to determine the DTA of FA/ME for the aetiological diagnostic in patients with suspected central nervous system(CNS) infection. Methods: We performed a systematic review with DTA meta-analysis (PROSPERO: CRD42020139285). We searched Embase, Medline (Ovid), and Web of Science from inception until September 1st, 2021. We assessed the study-level risk of bias with the QUADAS-2 tool and applied the GRADE approach to assess the certainty of the synthesised evidence. We included studies that simultaneously measured the reference test (CSF/blood culture for bacteria, and specific polymerase chain reaction for viruses) and the FA/ME in patients with suspected CNS infection. We performed random-effects bivariate meta-analysis models of combined sensitivity and specificity using CSF/blood cultures(reference test 1) and a final diagnosis adjudication based on clinical/laboratory criteria (reference test 2). Findings: We included 19 studies (11,351 participants). For all bacteria with reference test 1 (16 studies/6183 patients) sensitivity was estimated at 89·5% (95%CI 81·1-94·4), and specificity at 97·4% (95%CI 94-98·9). With reference test 2 (15 studies/5,524 patients), sensitivity was estimated at 92·1%(95%CI 86·8-95·3) and specificity at 99.2(95%CI 98·3-99·6) For herpes simplex virus-2(HSV-2), enteroviruses, and Varicella-Zoster virus (VZV), we obtained sensitivities between 75·5 and 93·8%, and specificities above 99% (reference test 1). Certainty of the evidence was low. Interpretation: FA/ME may have acceptable-to-high sensitivities and high specificities for identifying bacteria, especially for S.pneumoniae, and viruses, especially for HSV-2, and enteroviruses. Sensitivities for L.monocytogenes, H.influenzae, E.coli, and HSV-1 were suboptimal. Mención de responsabilidad : Juliana Trujillo-Gomez, Sofia Tsokani, Catalina Arango-Ferreira, Santiago Atehortua-Muñoz, Maria José Jimenez-Villegas, Carolina Serrano-Tabares, Areti-Angeliki Veroniki, and Ivan D. Florez Referencia : EClinicalMedicine. 2022 Feb 14;44:101275. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2022.101275 PMID : 35198914 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537022000050 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6011 Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis [documento electrónico] / Santiago León Atehortúa Muñoz,  . - 2022. Obra : eClinicalMedicine Idioma : Inglés (eng) Palabras clave : CNS infection  Diagnostic accuracy  Encephalitis  Film array  Meningitis  Meta-analysis  Multiplex PCR Resumen : Background: The FilmArray Meningitis/Encephalitis(FA/ME) panel brings benefits in clinical practice, but its diagnostic test accuracy (DTA) remains unclear. We aimed to determine the DTA of FA/ME for the aetiological diagnostic in patients with suspected central nervous system(CNS) infection. Methods: We performed a systematic review with DTA meta-analysis (PROSPERO: CRD42020139285). We searched Embase, Medline (Ovid), and Web of Science from inception until September 1st, 2021. We assessed the study-level risk of bias with the QUADAS-2 tool and applied the GRADE approach to assess the certainty of the synthesised evidence. We included studies that simultaneously measured the reference test (CSF/blood culture for bacteria, and specific polymerase chain reaction for viruses) and the FA/ME in patients with suspected CNS infection. We performed random-effects bivariate meta-analysis models of combined sensitivity and specificity using CSF/blood cultures(reference test 1) and a final diagnosis adjudication based on clinical/laboratory criteria (reference test 2). Findings: We included 19 studies (11,351 participants). For all bacteria with reference test 1 (16 studies/6183 patients) sensitivity was estimated at 89·5% (95%CI 81·1-94·4), and specificity at 97·4% (95%CI 94-98·9). With reference test 2 (15 studies/5,524 patients), sensitivity was estimated at 92·1%(95%CI 86·8-95·3) and specificity at 99.2(95%CI 98·3-99·6) For herpes simplex virus-2(HSV-2), enteroviruses, and Varicella-Zoster virus (VZV), we obtained sensitivities between 75·5 and 93·8%, and specificities above 99% (reference test 1). Certainty of the evidence was low. Interpretation: FA/ME may have acceptable-to-high sensitivities and high specificities for identifying bacteria, especially for S.pneumoniae, and viruses, especially for HSV-2, and enteroviruses. Sensitivities for L.monocytogenes, H.influenzae, E.coli, and HSV-1 were suboptimal. Mención de responsabilidad : Juliana Trujillo-Gomez, Sofia Tsokani, Catalina Arango-Ferreira, Santiago Atehortua-Muñoz, Maria José Jimenez-Villegas, Carolina Serrano-Tabares, Areti-Angeliki Veroniki, and Ivan D. Florez Referencia : EClinicalMedicine. 2022 Feb 14;44:101275. DOI (Digital Object Identifier) : 10.1016/j.eclinm.2022.101275 PMID : 35198914 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589537022000050 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6011

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Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
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AC-2022-017 Adobe Acrobat PDF

Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents / Andrea Victoria Restrepo Gouzy ; Mónica Rosa Trujillo Honeysberg    

Público ISBD Título : Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents Tipo de documento : documento electrónico Autores : Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg, Fecha de publicación : 2022 Títulos uniformes : BMC Pediatrics Idioma : Inglés (eng) Palabras clave : Pneumonia  Diagnosis  Etiology  Multiplex PCR  Serology  Induced sputum  Nasopharyngeal swab  Urine antigen  Children Resumen : Background: Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods: Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis, and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results: Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae, Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae, or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions: Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population. Mención de responsabilidad : Zulma Vanessa Rueda, Yudy Aguilar, María Angélica Maya, Lucelly López, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Mónica Trujillo, Catalina Arango, Ángela Rocio Copete, Cristian Vera, Margarita Rosa Giraldo, Mariana Herrera & Lázaro A. Vélez Referencia : BMC Pediatr. 2022 Mar 31;22(1):169. DOI (Digital Object Identifier) : 10.1186/s12887-022-03235-z PMID : 35361166 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03235-z Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6029 Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents [documento electrónico] / Andrea Victoria Restrepo Gouzy, ; Mónica Rosa Trujillo Honeysberg,  . - 2022. Obra : BMC Pediatrics Idioma : Inglés (eng) Palabras clave : Pneumonia  Diagnosis  Etiology  Multiplex PCR  Serology  Induced sputum  Nasopharyngeal swab  Urine antigen  Children Resumen : Background: Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods: Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis, and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results: Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae, Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae, or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions: Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population. Mención de responsabilidad : Zulma Vanessa Rueda, Yudy Aguilar, María Angélica Maya, Lucelly López, Andrea Restrepo, Carlos Garcés, Olga Morales, Claudia Roya-Pabón, Mónica Trujillo, Catalina Arango, Ángela Rocio Copete, Cristian Vera, Margarita Rosa Giraldo, Mariana Herrera & Lázaro A. Vélez Referencia : BMC Pediatr. 2022 Mar 31;22(1):169. DOI (Digital Object Identifier) : 10.1186/s12887-022-03235-z PMID : 35361166 Derechos de uso : CC BY En línea : https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03235-z Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6029

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Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
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AC-2022-035 Adobe Acrobat PDF