Trial reportChest2019
Rapid Detection of Methicillin-Resistant Staphylococcus aureus in BAL: A Pilot Randomized Controlled Trial.
Trial report in Chest, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02660554 (Rapid Diagnostic Testing to Guide Antibiotic Therapy in Drug Resistant Pneumonia), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Rapid Diagnostic Testing to Guide Antibiotic Therapy in Drug Resistant Pneumonia
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Accuracy of Molecular Amplification Assays for Diagnosis of Staphylococcal Pneumonia: a Systematic Review and Meta-analysis.Journal of clinical microbiology · 2021Pooled it
- Rapid and actionable nasal-swab screening supports antimicrobial stewardship in patients with pneumonia: a prospective study.Antimicrobial resistance and infection control · 2025Trial
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Pneumonia after Solid Organ Transplantation.Seminars in respiratory and critical care medicine · 2026Review
- Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Microbial cell-free DNA sequencing of bronchoalveolar lavage fluid improves diagnostic yield and may add clinical utility in immunocompromised patients with severe pneumonia.medRxiv : the preprint server for health sciences · 2025Article
- Antibiotic de-escalation patterns and outcomes in critically ill patients with suspected pneumonia as informed by bronchoalveolar lavage results.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Epidemiological profile and antimicrobial resistance trends of Staphylococcus aureus in Chinese pediatric intensive care units from 2016 to 2022: a multi-center retrospective study.BMC infectious diseases · 2025Article
- Respiratory tract infections: an update on the complexity of bacterial diversity, therapeutic interventions and breakthroughs.Archives of microbiology · 2024Review
- Rapid de-escalation of anti-MRSA therapy guided byFrontiers in medicine · 2024Article
- ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia.Intensive care medicine · 2023Article
- Trends in Molecular Diagnosis of Nosocomial Pneumonia Classic PCR vs. Point-of-Care PCR: A Narrative Review.Healthcare (Basel, Switzerland) · 2023Review
- Machine Learning To Stratify Methicillin-Resistant Staphylococcus aureus Risk among Hospitalized Patients with Community-Acquired Pneumonia.Antimicrobial agents and chemotherapy · 2023Article
- The threat of multidrug-resistant/extensively drug-resistant Gram-negative respiratory infections: another pandemic.European respiratory review : an official journal of the European Respiratory Society · 2022Article
- Decreasing incidence ofInfection control and hospital epidemiology · 2022Observational
- Ventilator-associated pneumonia.Intensive care medicine · 2022Article
- Clinical Relevance of Xpert MRSA/SA in Guiding Therapeutic Decisions for Staphylococcal Infections: A Diagnostic Test Accuracy Analysis.Infectious diseases and therapy · 2022Article
- Methicillin-Resistant Staphylococcus aureus Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia.Seminars in respiratory and critical care medicine · 2022Article
- Recent Developments in Phenotypic and Molecular Diagnostic Methods for Antimicrobial Resistance Detection inDiagnostics (Basel, Switzerland) · 2022Review
- Antibiotic-resistant bacteria: COVID-19 hasn't made the challenge go away.Respirology (Carlton, Vic.) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundGuidelines recommend empirical vancomycin or linezolid for patients with suspected pneumonia at risk for methicillin-resistant Staphylococcus aureus (MRSA). Unneeded vancomycin or linezolid use may unnecessarily alter host flora and expose patients to toxicity. We therefore sought to determine if rapid testing for MRSA in BAL can safely decrease use of vancomycin or linezolid for suspected MRSA pneumonia.
methodsOperating characteristics of the assay were initially validated against culture on residual BAL. A prospective, unblinded, randomized clinical trial to assess the effect of antibiotic management made on the basis of rapid diagnostic testing (RDT) compared with usual care was subsequently conducted, with primary outcome of duration of vancomycin or linezolid administration. Secondary end points focused on safety.
resultsSensitivity of RPCR was 95.7%, with a negative likelihood ratio of 0.04 for MRSA. The clinical trial randomized 45 patients: 22 to antibiotic management made on the basis of RDT and 23 to usual care. Duration of vancomycin or linezolid administration was significantly reduced in the intervention group (32 h [interquartile range, 22-48] vs 72 h [interquartile range, 50-113], P < .001). Proportions with complications and length of stay trended lower in the intervention group. Hospital mortality was 13.6% in the intervention group and 39.1% for usual care (95% CI of difference, -3.3 to 50.3, P = .06). Standardized mortality ratio was 0.48 for the intervention group and 1.18 for usual care.
conclusionsA highly sensitive BAL RDT for MRSA significantly reduced use of vancomycin and linezolid in ventilated patients with suspected pneumonia. Management made on the basis of RDT had no adverse effects, with a trend to lower hospital mortality. TRIAL REGISTRY: ClinicalTrials.gov; No. NCT02660554; URL: www.clinicaltrials.gov.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.