scholarly journals C-reactive protein point-of-care testing for lower respiratory tract infections: a qualitative evaluation of experiences by GPs

2009 ◽  
Vol 27 (2) ◽  
pp. 212-218 ◽  
Author(s):  
J. W L Cals ◽  
F. H F Chappin ◽  
R. M Hopstaken ◽  
M. E van Leeuwen ◽  
K. Hood ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Point Of Care ◽  
Qualitative Evaluation ◽  
Point Of Care Testing ◽  
C Reactive Protein ◽  
Lower Respiratory Tract Infections ◽  
Reactive Protein ◽  
Tract Infections

scholarly journals Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI

2020 ◽  
Vol 7 (1) ◽  
pp. e000624
Author(s):  
Jonathan Cooke ◽  
Carl Llor ◽  
Rogier Hopstaken ◽  
Matthew Dryden ◽  
Christopher Butler
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Point Of Care ◽  
Narrative Review ◽  
Economic Evaluations ◽  
Point Of Care Testing ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Tract Infections

Antimicrobial resistance (AMR) continues to be a global problem and continues to be addressed through national strategies to improve diagnostics, develop new antimicrobials and promote antimicrobial stewardship. Patients who attend general (ambulatory) practice with symptoms of respiratory tract infections (RTIs) are invariably assessed by some sort of clinical decision rule (CDR). However, CDRs rely on a cluster of non-specific clinical observations. A narrative review of the literature was undertaken to ascertain the value of C reactive protein (CRP) point-of-care testing (POCT) to guide antibacterial prescribing in adult patients presenting to general practitioner (GP) practices with symptoms of RTI. Studies that were included were Cochrane reviews, systematic reviews, randomised controlled trials, cluster randomised trials, controlled before and after studies, cohort studies and economic evaluations. An overwhelming number of studies demonstrated that the use of CRP tests in patients presenting with RTI symptoms reduces index antibacterial prescribing. GPs and patients report a good acceptability for a CRP POCT and economic evaluations show cost-effectiveness of CRP POCT over existing RTI management in primary care. POCTs increase diagnostic precision for GPs in the better management of patients with RTI. With the rapid development of artificial intelligence, patients will expect greater precision in diagnosing and managing their illnesses. Adopting systems that markedly reduce antibiotic consumption is a no-brainer for governments that are struggling to address the rise in AMR.

scholarly journals The Basics and the Advancements in Diagnosis of Bacterial Lower Respiratory Tract Infections

Diagnostics ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 37 ◽  
Author(s):  
Stephanie Noviello ◽  
David Huang
Keyword(s):  
Respiratory Tract ◽  
Cause Of Death ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Point Of Care ◽  
Patient Treatment ◽  
Resistant Bacteria ◽  
Lower Respiratory Tract Infections ◽  
Reactive Protein ◽  
Tract Infections

Lower respiratory tract infections (LRTIs) are the leading infectious cause of death and the sixth-leading cause of death overall worldwide. Streptococcus pneumoniae, with more than 90 serotypes, remains the most common identified cause of community-acquired acute bacterial pneumonia. Antibiotics treat LRTIs with a bacterial etiology. With the potential for antibiotic-resistant bacteria, defining the etiology of the LRTI is imperative for appropriate patient treatment. C-reactive protein and procalcitonin are point-of-care tests that may differentiate bacterial versus viral etiologies of LRTIs. Major advancements are currently advancing the ability to make rapid diagnoses and identification of the bacterial etiology of LRTIs, which will continue to support antimicrobial stewardship, and is the focus of this review.

scholarly journals A Pilot Study on the Diagnostic Accuracy of Proadrenomedullin and Proatrial Natriuretic Peptide in Lower Respiratory Tract Infections

2014 ◽  
Vol 8 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Agustín Ruiz-González ◽  
Aureli Esquerda ◽  
José M Porcel ◽  
Silvia Bielsa ◽  
Horacio Valencia ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Natriuretic Peptide ◽  
Plasma Levels ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Developed Countries ◽  
C Reactive Protein ◽  
Lower Respiratory Tract Infections ◽  
Reactive Protein ◽  
Tract Infections

Background : Pneumonia is the leading cause of death among infectious diseases in developed countries. However, the severity of pneumonia requiring hospitalization often makes the initial diagnosis difficult because of an equivocal clinical picture or interpretation of the chest film. The objective of the present study was to assess the usefulness of the plasma levels of mid-regional proadrenomedullin (MR-proADM) and mid-regional proatrial natriuretic peptide (MR-proANP) in differentiating pneumonia from other lower respiratory tract infections (LRTIs). Methods : A retrospective study was conducted. The plasma levels of MR-proADM and MR-proANP were measured in 85 patients hospitalized for LRTIs, 56 of whom with diagnosis of pneumonia and 29 with other LRTIs. Results : The patients with pneumonia had increased MR-proADM levels (median 1.46 nmol/L [IQR 25-75, 0.82-2.02 nmol/L]) compared with the patients with other LRTIs (median 0.88 nmol/mL [0.71-1.39 nmol/L]) (p= 0.04). However, the MR-proANP levels did not show differences between the groups. The optimal threshold of MR-proADM to predict pneumonia was 1.5 nmol/L, which yielded a sensitivity of 51.7% (95% CI, 38.0-65.3), a 79.3% specificity (95% CI, 60.3-92.0), and an odds ratio of 6.64 (95% CI, 1.32-32.85). The combination of this parameter with C-reactive protein in an “and” rule increased the specificity for detecting pneumonia significantly. Conclusion : MR-proADM levels (but not MR-proANP levels) are increased in patients with pneumonia although its discriminatory power is moderate.

scholarly journals Mycoplasma pneumoniae P1 genotype indicates severity of lower respiratory tract infections in children

2021 ◽  
Author(s):  
Jasna Rodman Berlot ◽  
Uroš Krivec ◽  
Tatjana Mrvič ◽  
Rok Kogoj ◽  
Darja Keše
Keyword(s):  
Respiratory Tract ◽  
Regression Model ◽  
Mycoplasma Pneumoniae ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
C Reactive Protein ◽  
Lower Respiratory Tract Infections ◽  
Pathogenic Potential ◽  
Reactive Protein ◽  
Tract Infections

Background. Mycoplasma pneumoniae (M. pneumoniae) strains can be classified into two major genetic groups, P1 type 1 (P1-1) and P1 type 2 (P1-2). It remains unknown if clinical manifestations of lower respiratory tract infections (LRTI) in children differ between the two genotypes. We aimed to determine if M. pneumoniae P1 genotype is associated with severity of LRTI in children. Methods. Medical charts of 420 children (≤ 15 years-old) with signs of acute LRTI who were PCR-positive for M. pneumoniae from pharyngeal swabs in a recent M. pneumoniae epidemic were analyzed. We used a culture and pyrosequencing approach for genotyping PCR-positive samples. We compared epidemiological and clinical data of children with either P1-1 or P1-2 LRTI. Results. P1-2-infected children presented with a significantly higher median baseline C-reactive protein level and were admitted to the hospital more often. P1 genotype had a significant predictive value in a multiple linear regression model predicting C-reactive protein levels in our study sample. Moreover, P1 genotype significantly affected the likelihood of hospital admission in a logistic regression model. Our modelling results were also confirmed on an additional, independent sample of children with M. pneumoniae LRTI. Conclusions. Results from our large patient group indicate that the two M. pneumoniae P1 genotypes may have different pathogenic potential and that LRTI with P1-2 strains may have a more severe disease course than those with P1-1 strains in children. P1 genotyping is not routinely performed, but could be used as a predictor of M. pneumoniae LRTI severity, enabling patient-tailored treatments.

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