Document Detail

Low utilisation of diagnostic microbiology for community acquired pneumonia in regional Victoria.
MedLine Citation:
PMID:  23250034     Owner:  NLM     Status:  Publisher    
AIMS:: Diagnostic microbiology for community acquired pneumonia (CAP) provides useful information for patient management, infection control and epidemiological surveillance. Newer techniques enhance that information and the time interval for obtaining results. An audit of diagnostic microbiology utilisation, microbiological aetiology, and influence of results on prescribing practices in CAP in a regional Australian hospital setting was performed. METHODS:: Clinical, microbiological and outcome data were collected by medical record review of patients discharged from Ballarat Hospital with a diagnosis of CAP over a 12 month period. RESULTS:: Of 184 identified CAP episodes, 47 (25.5%) had no diagnostic microbiology performed. Respiratory virus polymerase chain reaction (PCR) was rarely performed (2.7% of all episodes). Acute serology was frequently requested, however paired acute and convalescent serology was infrequently performed (5/75 testing episodes; 6.7%). CAP severity was not correlated with microbiological investigation intensity. The most common pathogens identified were Streptococcus pneumoniae and Mycoplasma pneumoniae (5.4% and 2.2%, respectively). Diagnostic testing appeared to rarely influence antimicrobial prescribing. CONCLUSIONS:: In this setting, diagnostic microbiological tests such as respiratory virus PCR and urinary antigen tests are under-utilised. In contrast, sputum and serological investigations are commonly requested, however rarely influence practice. Interventions to facilitate efficient usage of diagnostic microbiology are required.
Cameron J Jeremiah; Liam M Hannan; Rob Baird; Grant Phelps; Brett Knight
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-17
Journal Detail:
Title:  Pathology     Volume:  -     ISSN:  1465-3931     ISO Abbreviation:  Pathology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0175411     Medline TA:  Pathology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Division of Medicine, The Northern Hospital, Melbourne †Department of Infectious Diseases, St Vincent's Hospital, Melbourne ‡Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne §Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria ||Department of Microbiology, Royal Darwin Hospital, Darwin, Northern Territory ¶Consultant Physician and Medical Administrator, Ballarat **Ballarat Health Services, Ballarat, Victoria, Australia.
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