Academic Journal
Multiplex bacterial PCR in the bronchoalveolar lavage fluid of non-intubated patients with suspected pulmonary infection – a quasi-experimental study
| العنوان: | Multiplex bacterial PCR in the bronchoalveolar lavage fluid of non-intubated patients with suspected pulmonary infection – a quasi-experimental study |
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| المؤلفون: | Salina, Anna, Schumann, Desiree M., Franchetti, Léo, Jahn, Kathleen, Purkabiri, Kurosch, Müller, Raphael, Strobel, Werner, Khanna, Nina, Tamm, Michael, Stolz, Daiana |
| المصدر: | ERJ Open Research. - 8, 2 (2022) , 00595-2021, ISSN: 2312-0541 |
| سنة النشر: | 2022 |
| المجموعة: | University of Freiburg: FreiDok |
| الوصف: | Background Early pathogen identification in pulmonary infection is crucial to guide antibacterial therapy and decrease length of hospital stay. We hypothesise that compared to conventional diagnostic methods, a multiplex bacterial polymerase chain reaction assay has a higher diagnostic yield in bronchoalveolar lavage (BAL) fluid and improved clinical outcomes in patients with suspicion of pulmonary infection. Methods A prospective, monocentric, quasi-experimental, observational study was carried out. Unselected patients with suspected pulmonary infection who underwent bronchoscopy with BAL were included in the study over a period of 1 year. In addition to conventional diagnostic methods, a multiplex PCR bacterial assay was performed in BAL on a 2 week on: 1 week off pre-determined schedule. No therapeutic recommendations were provided to the treating physician. Results 605 cases were included, 54% of whom were immunosuppressed. Conventional diagnostic methods detected 56% of the bacteria evidenced by PCR. PCR failed to detect bacteria in 4% of the cases with a positive conventional diagnostic result. After bronchoscopy, 42% of the patients received antibacterial therapy for pulmonary infection for a median of 12 antibiotic days. There was no statistically significant difference in length of hospital stay (median 8 versus 8; p=0.839), antibiotic exposure (median 11 versus 14; p=0.362) or number of antibiotics prescribed (median 2 versus 2; p=0.595) between the two groups. Conclusions A multiplex bacterial PCR detected more bacteria in BAL fluid than conventional diagnostic methods. However, without a specific antibiotic stewardship approach and a clear understanding of the clinical implications of a positive or negative PCR result, the PCR results did not influence clinical outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | |
| اللغة: | English |
| Relation: | https://freidok.uni-freiburg.de/data/226743 |
| DOI: | 10.1183/23120541.00595-2021 |
| الاتاحة: | https://freidok.uni-freiburg.de/data/226743 https://nbn-resolving.org/urn:nbn:de:bsz:25-freidok-2267430 https://doi.org/10.1183/23120541.00595-2021 https://freidok.uni-freiburg.de/dnb/download/226743 |
| Rights: | free |
| رقم الانضمام: | edsbas.485ED860 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1183/23120541.00595-2021 |
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