Multiplex PCR Pneumonia Panel compared to Standard Culture of Respiratory specimens: Retrospective Results from a Transplant Centre.
Rapid identification of lower respiratory tract infection (LRTI) pathogens is critical for initiating early antimicrobial therapy. This study aimed at evaluating the role of multiplex polymerase chain reaction (mPCR) in detecting respiratory pathogens and antimicrobial resistance (AMR) at a transplant center.
The study was a single-centre, retrospective analysis, completed at a tertiary care transplant center. Data were included from 242 patients admitted with LRTI during a 24 months' period. Respiratory specimens were analysed through BioFire® PCR. Blood mPCR specimens were excluded (n=44). Multiplex PCR results were compared with the gold standard of culture and sensitivity testing.
Data from n=198 patients was included. The majority had a history of chronic hepatic or renal impairment (n=95; 48%) or liver/kidney transplantation (n=57; 28.8%). Chest imaging (n=162) predominantly revealed pleural effusions (35.2%) and parenchymal infiltrates (28.4%). Most common sample types included sputum (n=101; 51.0%) and tracheal aspirates (n=93; 47.0%). Following pathogen detections were recorded: 290 typical bacteria, 2 atypical organisms, and 95 viral detections. Klebsiella pneumoniae (32.3%) and Escherichia coli (28.8%) were most frequently identified. In n=102 patients with corresponding culture results, mPCR had sensitivity of 76% and specificity of 59%, with 66.7% concordance between methods. Multiplex PCR and culture identified multiple bacterial species in 38 (37.3%) and 17 (16.7%) cases, respectively. AMR gene analysis revealed high prevalence of CTX-M (30%), NDM (28%), and OXA-48-like (22%) mutations.
Multiplex PCR pneumonia panel demonstrated high sensitivity in detecting respiratory pathogens but had limitations in its specificity when compared to culture methods.
The study was a single-centre, retrospective analysis, completed at a tertiary care transplant center. Data were included from 242 patients admitted with LRTI during a 24 months' period. Respiratory specimens were analysed through BioFire® PCR. Blood mPCR specimens were excluded (n=44). Multiplex PCR results were compared with the gold standard of culture and sensitivity testing.
Data from n=198 patients was included. The majority had a history of chronic hepatic or renal impairment (n=95; 48%) or liver/kidney transplantation (n=57; 28.8%). Chest imaging (n=162) predominantly revealed pleural effusions (35.2%) and parenchymal infiltrates (28.4%). Most common sample types included sputum (n=101; 51.0%) and tracheal aspirates (n=93; 47.0%). Following pathogen detections were recorded: 290 typical bacteria, 2 atypical organisms, and 95 viral detections. Klebsiella pneumoniae (32.3%) and Escherichia coli (28.8%) were most frequently identified. In n=102 patients with corresponding culture results, mPCR had sensitivity of 76% and specificity of 59%, with 66.7% concordance between methods. Multiplex PCR and culture identified multiple bacterial species in 38 (37.3%) and 17 (16.7%) cases, respectively. AMR gene analysis revealed high prevalence of CTX-M (30%), NDM (28%), and OXA-48-like (22%) mutations.
Multiplex PCR pneumonia panel demonstrated high sensitivity in detecting respiratory pathogens but had limitations in its specificity when compared to culture methods.