A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.

<h4>Background</h4>Although culture-based methods remain a staple element of microbiology analysis, advanced molecular methods increasingly supplement the testing repertoire. Since the advent of 16s and 18s ribosomal RNA PCR in the 2000s, there has been interest in its utility for pathog...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	TeeKeat Teoh, Rachel McNamara, James Powell, Nuala H O'Connell, Colum P Dunne
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/431f3a9858c64b729d3b15ee7d282bd7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:431f3a9858c64b729d3b15ee7d282bd7
record_format	dspace
spelling	oai:doaj.org-article:431f3a9858c64b729d3b15ee7d282bd72021-12-02T20:19:17ZA retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.1932-620310.1371/journal.pone.0258552https://doaj.org/article/431f3a9858c64b729d3b15ee7d282bd72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258552https://doaj.org/toc/1932-6203<h4>Background</h4>Although culture-based methods remain a staple element of microbiology analysis, advanced molecular methods increasingly supplement the testing repertoire. Since the advent of 16s and 18s ribosomal RNA PCR in the 2000s, there has been interest in its utility for pathogen detection. Nonetheless, studies assessing the impact on antimicrobial prescribing are limited. We report a single-centre experience of the influence of 16s and 18s PCR testing on antimicrobial treatment, including a cost-analysis.<h4>Methods</h4>Data were collected retrospectively for all samples sent for 16s and 18s PCR testing between January 2014 and December 2020. Results were compared to any culture-based result. Assessment focused on any change of antimicrobial treatment based on PCR result, or use of the result as supportive evidence for microbiological diagnosis.<h4>Results</h4>310 samples relevant to 268 patients were referred for 16s/18s rRNA PCR testing during the period. Culture was performed for 234 samples. Enrichment culture was performed for 83 samples. 82 of 300 samples sent for 16s PCR had positive results (20.8%). When culture was performed, enrichment reduced the outcome of 16s PCR only positive results (4/36 [11.1%] versus 14/35 [40.0%], p = 0.030 where a pathogen found). 18s PCR yielded 9 positive results from 67 samples. The 16s PCR result influenced antimicrobial change for 6 patients (2.2%). We estimated the cost for 16s PCR testing to result in one significant change in antimicrobial therapy to be €3,340. 18s PCR did not alter antimicrobial treatment.<h4>Conclusion</h4>There was limited impact of 16s PCR results on antimicrobial treatments. Relevance to practice was affected by relatively long turn-around-time for results. Utility may be increased in specialised surgical centres, or by reducing turn-around-time. Enrichment culture should be considered on samples where 16s PCR is requested. There remains limited evidence for use of 18s PCR in clinical management, and further studies in this area are likely warranted.TeeKeat TeohRachel McNamaraJames PowellNuala H O'ConnellColum P DunnePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258552 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q TeeKeat Teoh Rachel McNamara James Powell Nuala H O'Connell Colum P Dunne A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
description	<h4>Background</h4>Although culture-based methods remain a staple element of microbiology analysis, advanced molecular methods increasingly supplement the testing repertoire. Since the advent of 16s and 18s ribosomal RNA PCR in the 2000s, there has been interest in its utility for pathogen detection. Nonetheless, studies assessing the impact on antimicrobial prescribing are limited. We report a single-centre experience of the influence of 16s and 18s PCR testing on antimicrobial treatment, including a cost-analysis.<h4>Methods</h4>Data were collected retrospectively for all samples sent for 16s and 18s PCR testing between January 2014 and December 2020. Results were compared to any culture-based result. Assessment focused on any change of antimicrobial treatment based on PCR result, or use of the result as supportive evidence for microbiological diagnosis.<h4>Results</h4>310 samples relevant to 268 patients were referred for 16s/18s rRNA PCR testing during the period. Culture was performed for 234 samples. Enrichment culture was performed for 83 samples. 82 of 300 samples sent for 16s PCR had positive results (20.8%). When culture was performed, enrichment reduced the outcome of 16s PCR only positive results (4/36 [11.1%] versus 14/35 [40.0%], p = 0.030 where a pathogen found). 18s PCR yielded 9 positive results from 67 samples. The 16s PCR result influenced antimicrobial change for 6 patients (2.2%). We estimated the cost for 16s PCR testing to result in one significant change in antimicrobial therapy to be €3,340. 18s PCR did not alter antimicrobial treatment.<h4>Conclusion</h4>There was limited impact of 16s PCR results on antimicrobial treatments. Relevance to practice was affected by relatively long turn-around-time for results. Utility may be increased in specialised surgical centres, or by reducing turn-around-time. Enrichment culture should be considered on samples where 16s PCR is requested. There remains limited evidence for use of 18s PCR in clinical management, and further studies in this area are likely warranted.
format	article
author	TeeKeat Teoh Rachel McNamara James Powell Nuala H O'Connell Colum P Dunne
author_facet	TeeKeat Teoh Rachel McNamara James Powell Nuala H O'Connell Colum P Dunne
author_sort	TeeKeat Teoh
title	A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
title_short	A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
title_full	A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
title_fullStr	A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
title_full_unstemmed	A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.
title_sort	retrospective observational study of the impact of 16s and 18s ribosomal rna pcr on antimicrobial treatment over seven years: a tertiary hospital experience.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/431f3a9858c64b729d3b15ee7d282bd7
work_keys_str_mv	AT teekeatteoh aretrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT rachelmcnamara aretrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT jamespowell aretrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT nualahoconnell aretrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT columpdunne aretrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT teekeatteoh retrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT rachelmcnamara retrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT jamespowell retrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT nualahoconnell retrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience AT columpdunne retrospectiveobservationalstudyoftheimpactof16sand18sribosomalrnapcronantimicrobialtreatmentoversevenyearsatertiaryhospitalexperience
_version_	1718374219390124032

A retrospective observational study of the impact of 16s and 18s ribosomal RNA PCR on antimicrobial treatment over seven years: A tertiary hospital experience.

Ejemplares similares