Опыт использования синдромальных подходов к диагностике респираторных инфекций

Abstract

Irrational or excessive use of antibiotics, the absence or insufficient use of rapid diagnostics tests at the point of care ("POC"), as well as insufficient infection control are key factors in the development of multi- and pan-resistance to antibiotics. The article presents the clinical experience of using the syndromic approach Patients and methods. The work was carried out on the basis of the Morozovskaya State children's hospital from February to June 2022 in accordance with the standards of medical care for patients with acute respiratory infections using multiplex PCR test (mPCR) – BioFire FilmArray respiratory panel (BioFire RP). The study included inpatient children (n = 40) with symptoms of acute respiratory infections and respiratory failure (DN) of different severity. Results. The analysis of the nosological structure showed that acute obstructive bronchitis/acute bronchitis (J20.9) was found in 47.5%, pneumonia (J18.9) in 20% of children, acute bronchiolitis (J21.9) at 7.5%, other viral lesions of the respiratory tract (J00-J06) – 25%. The standard PCR ARVI panel identified pathogens in 45% (n = 18), the BioFire RP panel in 55% (n = 22) of patients (p = 0.503). An important indicator is the speed of obtaining results. The median time from the moment of taking the smear to the moment of transmitting the result to the physician was 2.56 hours (CI: 1.91–3.62) when examined using the BioFire RP panel compared with 28.4 hours (CI: 9.64–33) when using standard PCR diagnostics for respiratory viruses (p < 0.001). Conclusion. Methods of rapid molecular diagnostics can reduce the time of hospitalization of patients. In the study, the duration of hospitalization is 1 day shorter compared to the analysis of retrospective indicators of hospitalization terms. This is due to the ability to quickly identify the agent of respiratory infection, which in turn affects the tactics of treatment, optimizes the appointment of antibiotics, which affects to the duration of hospitalization. Key words: respiratory infection, BioFire, PCR, virus, rapid diagnosis, etiotropic therapy