Respiratory multiplex PCR and procalcitonin to reduce antibiotic exposure in severe SARS-CoV-2 pneumonia: a multicentre randomized controlled trial

Article Critical Care Medicine

Fast multiplex bacterial PCR of bronchoalveolar lavage for antibiotic stewardship in hospitalised patients with pneumonia at risk of Gram-negative bacterial infection (Flagship II): a multicentre, randomised controlled trial

Andrei M. Darie et al.

Summary: Multiplex bacterial PCR examination of bronchoalveolar lavage decreases the duration of inappropriate antibiotic therapy in patients with pneumonia.

LANCET RESPIRATORY MEDICINE (2022)

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Article Infectious Diseases

Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study

Clark D. Russell et al.

Summary: Microbiologically confirmed bacterial infections are rare in patients admitted with COVID-19, mostly being secondary infections. Gram-negative organisms and S aureus are the predominant pathogens. Antimicrobial use is frequent, but can be intervened with stewardship measures.

LANCET MICROBE (2021)

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Review Infectious Diseases

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Bradley J. Langford et al.

Summary: The study estimated that approximately three-quarters of patients with COVID-19 receive antibiotic treatment, which is significantly higher than the estimated prevalence of bacterial co-infection. This suggests a potential for high rates of unnecessary antibiotic use in patients with COVID-19.

CLINICAL MICROBIOLOGY AND INFECTION (2021)

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Letter Infectious Diseases

Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia

Alexandre Elabbadi et al.

Summary: The study found a high prevalence of bacterial coinfection in critically ill patients with severe COVID-19 pneumonia upon ICU admission, with Staphylococcus aureus being the main pathogen identified.

INFECTION (2021)

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Review Multidisciplinary Sciences

Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis

Jackson S. Musuuza et al.

Summary: Our study found that as many as 19% of patients with COVID-19 had co-infections and 24% had superinfections. The presence of either co-infection or superinfection was associated with poor outcomes, such as increased mortality.

PLOS ONE (2021)

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Article Critical Care Medicine

Early Bacterial Identification among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Clinical Trial

Anahita Rouze et al.

Summary: The prevalence of bacterial identification within 48 hours after intubation is significantly lower in patients with SARSCoV-2 pneumonia compared to influenza pneumonia. Bacterial identification is associated with increased 28-day mortality in patients with SARS-CoV-2 pneumonia.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

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Article Medicine, General & Internal

Combined use of a broad-panel respiratory multiplex PCR and procalcitonin to reduce duration of antibiotics exposure in patients with severe community-acquired pneumonia (MULTI-CAP): a multicentre, parallel-group, open-label, individual randomised trial conducted in French intensive care units

Guillaume Voiriot et al.

Summary: The MULTI-CAP trial aims to compare the use of multiplex PCR and procalcitonin in reducing duration of antibiotic exposure in severe-CAP patients. The trial includes 20 centers and involves adult patients admitted for CAP, with a diagnosis based on clinical criteria and a newly appeared parenchymal infiltrate. Immunosuppressed patients are excluded. The intervention arm involves a combination of respiratory multiplex PCR and conventional microbiological investigations for microbiological diagnosis, with an algorithm for early antibiotic de-escalation or discontinuation based on results.

BMJ OPEN (2021)

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Article Critical Care Medicine