Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections
The use of 16S rRNA sequencing in culture-negative infections has improved identification of bacterial pathogens in select scenarios, but its clinical impact requires further elucidation, especially in the pediatric population. This retrospective study aims to determine the clinical utility of 16S r...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/2/159 |
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| author | Peter Paul C. Lim Lisa M. Stempak Sindhoosha Malay LeAnne N. Moore Sree Sarah S. Cherian Ankita P. Desai |
| author_facet | Peter Paul C. Lim Lisa M. Stempak Sindhoosha Malay LeAnne N. Moore Sree Sarah S. Cherian Ankita P. Desai |
| author_sort | Peter Paul C. Lim |
| collection | DOAJ |
| description | The use of 16S rRNA sequencing in culture-negative infections has improved identification of bacterial pathogens in select scenarios, but its clinical impact requires further elucidation, especially in the pediatric population. This retrospective study aims to determine the clinical utility of 16S rRNA sequencing on the clinical management of pediatric culture-negative infections in our institution. Significant clinical utility was identified in 30 (40.5%) of 74 clinical samples (<i>p</i> < 0.0001). Of all specimens, pulmonary samples yielded the most clinical utility (<i>n</i> = 9, 30%), followed equally by joint fluid (<i>n</i> = 6, 20%) and bone (<i>n</i> = 6, 20%), with no difference between fluid and fresh tissue specimens (<i>p =</i> 0.346). Although the difference was not statistically significant (<i>p</i> = 0.4111), the overall use of broad-spectrum coverage was decreased. The median number of antibiotics was decreased from two to one (<i>p</i> < 0.0001) based on 16S rRNA sequencing results. The results suggest that 16S rRNA sequencing has a significant impact on decreasing the number of antibiotics used in the treatment of pediatric culture-negative infections. 16S rRNA sequencing performed on pulmonary specimens has the highest likelihood of identifying a pathogen compared to other specimen types. Additional cost–benefit analysis needs to be completed to further determine clinical benefit. |
| first_indexed | 2024-03-09T22:47:10Z |
| format | Article |
| id | doaj.art-2b534a521b9b405490e821f2d8f960f1 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T22:47:10Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-2b534a521b9b405490e821f2d8f960f12023-11-23T18:27:25ZengMDPI AGAntibiotics2079-63822022-01-0111215910.3390/antibiotics11020159Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric InfectionsPeter Paul C. Lim0Lisa M. Stempak1Sindhoosha Malay2LeAnne N. Moore3Sree Sarah S. Cherian4Ankita P. Desai5Department of Pediatric Infectious Diseases, University Hospitals-Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USADepartment of Pathology, University Hospitals-Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USADepartment of Clinical Research Biostatistics, University Hospitals-Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USADepartment of Pediatric Pharmacy, University Hospitals-Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USADepartment of Pathology, University Hospitals-Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USADepartment of Pediatric Infectious Diseases, University Hospitals-Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USAThe use of 16S rRNA sequencing in culture-negative infections has improved identification of bacterial pathogens in select scenarios, but its clinical impact requires further elucidation, especially in the pediatric population. This retrospective study aims to determine the clinical utility of 16S rRNA sequencing on the clinical management of pediatric culture-negative infections in our institution. Significant clinical utility was identified in 30 (40.5%) of 74 clinical samples (<i>p</i> < 0.0001). Of all specimens, pulmonary samples yielded the most clinical utility (<i>n</i> = 9, 30%), followed equally by joint fluid (<i>n</i> = 6, 20%) and bone (<i>n</i> = 6, 20%), with no difference between fluid and fresh tissue specimens (<i>p =</i> 0.346). Although the difference was not statistically significant (<i>p</i> = 0.4111), the overall use of broad-spectrum coverage was decreased. The median number of antibiotics was decreased from two to one (<i>p</i> < 0.0001) based on 16S rRNA sequencing results. The results suggest that 16S rRNA sequencing has a significant impact on decreasing the number of antibiotics used in the treatment of pediatric culture-negative infections. 16S rRNA sequencing performed on pulmonary specimens has the highest likelihood of identifying a pathogen compared to other specimen types. Additional cost–benefit analysis needs to be completed to further determine clinical benefit.https://www.mdpi.com/2079-6382/11/2/15916S rRNA sequencingbroad-range PCRantibiotic stewardshipculture-negative infectionpediatrics |
| spellingShingle | Peter Paul C. Lim Lisa M. Stempak Sindhoosha Malay LeAnne N. Moore Sree Sarah S. Cherian Ankita P. Desai Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections Antibiotics 16S rRNA sequencing broad-range PCR antibiotic stewardship culture-negative infection pediatrics |
| title | Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections |
| title_full | Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections |
| title_fullStr | Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections |
| title_full_unstemmed | Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections |
| title_short | Determining the Clinical Utility of 16S rRNA Sequencing in the Management of Culture-Negative Pediatric Infections |
| title_sort | determining the clinical utility of 16s rrna sequencing in the management of culture negative pediatric infections |
| topic | 16S rRNA sequencing broad-range PCR antibiotic stewardship culture-negative infection pediatrics |
| url | https://www.mdpi.com/2079-6382/11/2/159 |
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