38
Views
0
CrossRef citations to date
0
Altmetric
Research Article

Syndromic testing for respiratory pathogens but not National Early Warning Score can be used to identify viral cause in hospitalised adults with lower respiratory tract infections

, , , , & ORCID Icon
Received 31 Oct 2023, Accepted 18 Mar 2024, Published online: 02 Apr 2024

References

  • Greene G, Hood K, Little P, et al. Towards clinical definitions of lower respiratory tract infection (LRTI) for research and primary care practice in Europe: an International Consensus Study. Prim Care Respir J. 2011;20(3):299–306. doi: 10.4104/pcrj.2011.00034.
  • Aliberti S, Dela Cruz CS, Amati F, et al. Community-acquired pneumonia. Lancet. 2021;398(10303):906–919. doi: 10.1016/S0140-6736(21)00630-9.
  • Gadsby NJ, Russell CD, McHugh MP, et al. Comprehensive molecular testing for respiratory pathogens in community-acquired pneumonia. Clin Infect Dis. 2016;62(7):817–823. doi: 10.1093/cid/civ1214.
  • Noviello S, Huang DB. The basics and the advancements in diagnosis of bacterial lower respiratory tract infections. Diagnostics. 2019;9(2):37. doi: 10.3390/diagnostics9020037.
  • Kraus EM, Pelzl S, Szecsenyi J, et al. Antibiotic prescribing for acute lower respiratory tract infections (LRTI) – guideline adherence in the German Primary Care Setting: an analysis of routine data. PLOS One. 2017;12(3):e0174584. doi: 10.1371/journal.pone.0174584.
  • Jain S, Self WH, Wunderink RG, et al. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415–427. doi: 10.1056/NEJMoa1500245.
  • Clark TW, Medina MJ, Batham S, et al. Adults hospitalised with acute respiratory illness rarely have detectable bacteria in the absence of COPD or pneumonia; viral infection predominates in a large prospective UK sample. J Infect. 2014;69(5):507–515. doi: 10.1016/j.jinf.2014.07.023.
  • Brendish NJ, Malachira AK, Armstrong L, et al. Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial. Lancet Respir Med. 2017;5(5):401–411. doi: 10.1016/S2213-2600(17)30120-0.
  • Brittain-Long R, Westin J, Olofsson S, et al. Access to a polymerase chain reaction assay method targeting 13 respiratory viruses can reduce antibiotics: a randomised, controlled trial. BMC Med. 2011;9(1):44. doi: 10.1186/1741-7015-9-44.
  • Burk M, El-Kersh K, Saad M, et al. Viral infection in community-acquired pneumonia: a systematic review and meta-analysis. Eur Respir Rev. 2016;25(140):178–188. doi: 10.1183/16000617.0076-2015.
  • Jennings LC, Anderson TP, Beynon KA, et al. Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax. 2008;63(1):42–48. doi: 10.1136/thx.2006.075077.
  • Johansson N, Kalin M, Hedlund J. Clinical impact of combined viral and bacterial infection in patients with community-acquired pneumonia. Scand J Infect Dis. 2011;43(8):609–615. doi: 10.3109/00365548.2011.570785.
  • Self WH, Williams DJ, Zhu Y, et al. Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia. J Infect Dis. 2016;213(4):584–591. doi: 10.1093/infdis/jiv323.
  • Sundell N, Andersson L-M, Brittain-Long R, et al. PCR detection of respiratory pathogens in asymptomatic and symptomatic adults. J Clin Microbiol. 2019;57(1):e00716-18. doi: 10.1128/JCM.00716-18.
  • Brink A, Alsma J, Verdonschot R, et al. Predicting mortality in patients with suspected sepsis at the emergency department; a retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLOS One. 2019;14(1):e0211133. doi: 10.1371/journal.pone.0211133.
  • Sbiti-Rohr D, Kutz A, Christ-Crain M, et al. The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study. BMJ Open. 2016;6(9):e011021. doi: 10.1136/bmjopen-2015-011021.
  • McNally M, Curtain J, O'Brien KK, et al. Validity of British Thoracic Society Guidance (the CRB-65 rule) for predicting the severity of pneumonia in general practice: systematic review and meta-analysis. Br J Gen Pract. 2010;60(579):e423–e433. doi: 10.3399/bjgp10X532422.
  • Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections – full version. Clin Microbiol Infect. 2011;17(Suppl. 6):E1–E59. doi: 10.1111/j.1469-0691.2011.03672.x.
  • Lim WS, Baudouin SV, George RC, et al. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009;64(Suppl. 3):iii1–iii55. doi: 10.1136/thx.2009.121434.
  • Brittain-Long R, Nord S, Olofsson S, et al. Multiplex real-time PCR for detection of respiratory tract infections. J Clin Virol. 2008;41(1):53–56. doi: 10.1016/j.jcv.2007.10.029.
  • Andersson ME, Olofsson S, Lindh M. Comparison of the FilmArray assay and in-house real-time PCR for detection of respiratory infection. Scand J Infect Dis. 2014;46(12):897–901. doi: 10.3109/00365548.2014.951681.
  • Fjelltveit EB, Cox RJ, Østensjø J, et al. Point-of-care influenza testing impacts clinical decision, patient flow, and length of stay in hospitalized adults. J Infect Dis. 2022;226(1):97–108. doi: 10.1093/infdis/jiaa690.
  • Lankelma JM, Hermans MHA, Hazenberg E, et al. Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital. Neth J Med. 2019;77(3):109–115.
  • Martinot M, Greigert V, Gravier S, et al. Positive impact of a point-of-care molecular influenza test in the emergency department during the 2017–2018 seasonal influenza epidemic. Open Forum Infect Dis. 2019;6(7):ofz312.
  • Berwa A, Gallouche M, Larrat S, et al. Effect of point-of-care influenza tests on antibiotic prescriptions by emergency physicians in a French hospital. J Hosp Infect. 2022;122:133–139. doi: 10.1016/j.jhin.2022.01.014.
  • Andreeva E, Melbye H. Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group. BMC Fam Pract. 2014;15(1):80. doi: 10.1186/1471-2296-15-80.
  • Le Bel J, Hausfater P, Chenevier-Gobeaux C, et al. Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan. Crit Care. 2015;19(1):366. doi: 10.1186/s13054-015-1083-6.
  • Stolz D, Christ-Crain M, Gencay MM, et al. Diagnostic value of signs, symptoms and laboratory values in lower respiratory tract infection. Swiss Med Wkly. 2006;136(27–28):434–440. doi: 10.4414/smw.2006.11271.
  • Bauer TT, Ewig S, Marre R, et al. CRB-65 predicts death from community-acquired pneumonia. J Intern Med. 2006;260(1):93–101. doi: 10.1111/j.1365-2796.2006.01657.x.
  • Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis. Thorax. 2010;65(10):878–883. doi: 10.1136/thx.2009.133280.
  • Loke YK, Kwok CS, Niruban A, et al. Value of severity scales in predicting mortality from community-acquired pneumonia: systematic review and meta-analysis. Thorax. 2010;65(10):884–890. doi: 10.1136/thx.2009.134072.
  • Strålin K, Olcén P, Törnqvist E, et al. Definite, probable, and possible bacterial aetiologies of community-acquired pneumonia at different CRB-65 scores. Scand J Infect Dis. 2010;42(6–7):426–434. doi: 10.3109/00365540903552353.
  • Bjarnason A, Lindh M, Westin J, et al. Utility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults. Eur J Clin Microbiol Infect Dis. 2017;36(3):529–536. doi: 10.1007/s10096-016-2829-z.
  • Strålin K, Törnqvist E, Kaltoft MS, et al. Etiologic diagnosis of adult bacterial pneumonia by culture and PCR applied to respiratory tract samples. J Clin Microbiol. 2006;44(2):643–645. doi: 10.1128/JCM.44.2.643-645.2006.
  • Wu X, Wang Q, Wang M, et al. Incidence of respiratory viral infections detected by PCR and real-time PCR in adult patients with community-acquired pneumonia: a meta-analysis. Respiration. 2015;89(4):343–352. doi: 10.1159/000369561.
  • Zhou F, Wang Y, Liu Y, et al. Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network. Eur Respir J. 2019;54(2):1802406. doi: 10.1183/13993003.02406-2018.
  • Qu J-X, Gu L, Pu Z-H, et al. Viral etiology of community-acquired pneumonia among adolescents and adults with mild or moderate severity and its relation to age and severity. BMC Infect Dis. 2015;15(1):89. doi: 10.1186/s12879-015-0808-0.
  • Crotty MP, Meyers S, Hampton N, et al. Epidemiology, co-infections, and outcomes of viral pneumonia in adults: an observational cohort study. Medicine. 2015;94(50):e2332. doi: 10.1097/MD.0000000000002332.
  • Sundell N, Andersson LM, Brittain-Long R, et al. A four year seasonal survey of the relationship between outdoor climate and epidemiology of viral respiratory tract infections in a temperate climate. J Clin Virol. 2016;84:59–63. doi: 10.1016/j.jcv.2016.10.005.
  • Hamid S, Winn A, Parikh R, et al. Seasonality of respiratory syncytial virus – United States, 2017–2023. MMWR Morb Mortal Wkly Rep. 2023;72(14):355–361. doi: 10.15585/mmwr.mm7214a1.
  • The Public Health Agency of Sweden. Influenza in Sweden – season 2022–2023. The Public Health Agency of Sweden; 2023 [cited 2023 Sep 28]. Report No.: 23162. Contract No.: 23162.
  • Munkstrup C, Lomholt FK, Emborg HD, et al. Early and intense epidemic of respiratory syncytial virus (RSV) in Denmark, August to December 2022. Euro Surveill. 2023;28(1):2200937. doi: 10.2807/1560-7917.ES.2023.28.1.2200937.
  • Royal College of physicians. National Early Warning Score (NEWS) 2: standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: Royal College of Physicians; 2017.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.