Epidemiology of Lower Respiratory Tract Infections in Hospitalized Patients Using Multiplex PCR in Central Greece
DOI:
https://doi.org/10.5644/ama2006-124.517Keywords:
Lower Respiratory Tract Infections, Multiplex PCR, Molecular DiagnosticsAbstract
Objective. This study investigated the epidemiology of LRTIs using multiplex Polymerase Chain Reaction (mPCR) at the General Hospital of Larissa.
Methods. This retrospective observational study was conducted from January 2021 to June 2024 and included 210 patients with suspected LRTIs. Respiratory specimens, comprising bronchoalveolar lavage and sputum samples, were analyzed using the Biofire Filmarray Pneumonia Panel Plus (BFPP; Biofire, bioMérieux), which detects a wide spectrum of bacterial, viral, and atypical respiratory pathogens.
Results. The most frequently detected pathogens were Pseudomonas ae- ruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, predominantly in patients admitted to the Intensive Care Unit. In contrast, specimens from the Department of Internal Medicine most often yielded Haemophilus influenzae, Staphylococcus aureus, and human rhinovirus/enterovirus. Overall, bacterial pathogens were more prevalent than viral pathogens. The use of mPCR enabled the rapid detection of respiratory pathogens and provided critical epidemiological insights into LRTI distribu- tion across hospital departments.
Conclusions. mPCR is a useful adjunctive tool for the detection of respiratory pathogens in patients with LRTIs and may support clinical decision-making if interpreted in the clinical context. The integration of molecular diagnostics into routine clinical practice may improve infection management and surveillance. Further multicenter studies and comparisons with conventional diagnostic methods are warranted to evaluate its impact on antimicrobial stewardship, clinical decision-making, and patient outcomes.
References
Ibn Saied W, Mourvillier B, Cohen Y, Ruckly S, Reignier J, Marcotte G, et al. A Comparison of the Mortality Risk Associated With Ventilator-Acquired Bacterial Pneumonia and Nonventilator ICU-Acquired Bacterial Pneumonia. Crit Care Med. 2019;47(3):345-52.
Grossman RF, Rotschafer JC, Tan JS. Antimicrobial treatment of lower respiratory tract infections in the hospital setting. Am J Med. 2005;118 Suppl 7A:29s-38s.
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67.
Bajaj SK, Tombach B. Respiratory infections in immunocompromised patients: Lung findings using chest computed tomography. Radiol Infect Dis. 2017;4(1):29-37.
Koulenti D, Tsigou E, Rello J. Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EUVAP/CAP study. Eur J Clin Microbiol Infect Dis. 2017;36(11):1999-2006.
Strålin KA-O, Ehn F, Giske CG, Ullberg M, Hedlund J, Petersson J, et al. The IRIDICA PCR/Electrospray Ionization-Mass Spectrometry Assay on Bronchoalveolar Lavage for Bacterial Etiology in Mechanically Ventilated Patients with Suspected Pneumonia. (1932-6203 (Electronic)).
Xie Y, Du J, Jin W, Teng X, Cheng R, Huang P, et al. Next generation sequencing for diagnosis of severe pneumonia: China, 2010-2018. (1532-2742 (Electronic)).
Frank E, Liu J, Kinasewitz G, Moran GJ, Oross MP, Olson WH, et al. A multicenter, open-label, randomized comparison of levofloxacin and azithromycin plus ceftriaxone in hospitalized adults with moderate to severe community-acquired pneumonia. Clin Ther. 2002;24(8):1292-308.
Talebi Bezmin Abadi A, Rizvanov AA, Haertlé T, Blatt NL. World Health Organization Report: Current Crisis of Antibiotic Resistance. BioNanoScience. 2019;9(4):778-88.
Peralta G, Sánchez MB, Garrido JC, De Benito I, Cano ME, Martínez-Martínez L, et al. Impact of antibiotic resistance and of adequate empirical antibiotic treatment in the prognosis of patients with Escherichia coli bacteraemia. J Antimicrob Chemother. 2007;60(4):855-63.
Kollef MA-O, Shorr AF, Bassetti M, Timsit JF, Micek ST, Michelson AP, et al. Timing of antibiotic therapy in the ICU. (1466-609X (Electronic)).
Lai CC, Chen YS, Lee NY, Tang HJ, Lee SS, Lin CF, et al. Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents: results from Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART). (1178-6973 (Print)).
Kosai K, Akamatsu N, Ota K, Mitsumoto-Kaseida F, Sakamoto K, Hasegawa H, et al. BioFire FilmArray Pneumonia Panel enhances detection of pathogens and antimicrobial resistance in lower respiratory tract specimens. Ann Clin Microbiol Antimicrob. 2022;21(1):24.
Chen CL, Tseng HY, Chen WC, Liang SJ, Tu CY, Lin YC, et al. Application of a multiplex molecular pneumonia panel and real-world impact on antimicrobial stewardship among patients with hospital-acquired and ventilator-associated pneumonia in intensive care units. J Microbiol Immunol Infect. 2024;57(3):480-9.
Cartuliares MB, Skjøt-Arkil H, Mogensen CB, Skovsted TA, Andersen SL, Pedersen AK, et al. Gram Stain and Culture of Sputum Samples Detect Only Few Pathogens in Community-Acquired Lower Respiratory Tract Infections: Secondary Analysis of a Randomized Controlled Trial. Diagnostics (Basel). 2023;13(4).
BioFire (2021). FilmArray pneumonia panel plus instruction booklet RFIT-PRT-0895-03 February 2021 (Salt Lake City, UT: BioFire).
Jitmuang A, Puttinad S, Hemvimol S, Pansasiri S, Horthongkham N. A multiplex pneumonia panel for diagnosis of hospital-acquired and ventilator-associated pneumonia in the era of emerging antimicrobial resistance. Front Cell Infect Microbiol. 2022;12:977320.
Hunter JD. Ventilator associated pneumonia. Bmj. 2012;344:e3325.
Moore LS, Freeman R, Gilchrist MJ, Gharbi M, Brannigan ET, Donaldson H, et al. Homogeneity of antimicrobial policy, yet heterogeneity of antimicrobial resistance: antimicrobial non-susceptibility among 108,717 clinical isolates from primary, secondary and tertiary care patients in London. J Antimicrob Chemother. 2014;69(12):3409-22.
Lee SH, Ruan SY, Pan SC, Lee TF, Chien JY, Hsueh PR. Performance of a multiplex PCR pneumonia panel for the identification of respiratory pathogens and the main determinants of resistance from the lower respiratory tract specimens of adult patients in intensive care units. J Microbiol Immunol Infect. 2019;52(6):920-8.
Karolyi M, Pawelka E, Hind J, Baumgartner S, Friese E, Hoepler W, et al. Detection of bacteria via multiplex PCR in respiratory samples of critically ill COVID-19 patients with suspected HAP/VAP in the ICU. Wien Klin Wochenschr. 2022;134(9-10):385-90.
Downloads
Published
License
Copyright (c) 2026 Ioanna Argyrakouli, Georgios Meletis, Sofia Argyrakouli, Efthymia Protonotariou, Melania Kachrimanidou
This work is licensed under a Creative Commons Attribution 4.0 International License.
