Multiplex bacterial polymerase chain reaction in a cohort of patients with pleural effusion.
- Franchetti L Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
- Schumann DM Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland. desiree.schumann@usb.ch.
- Tamm M Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
- Jahn K Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
- Stolz D Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
- 2020-02-03
Published in:
- BMC infectious diseases. - 2020
Bacteria
Multiplex PCR
Para-pneumonic effusion
Pathogen
Pleural empyema
Aged
Aged, 80 and over
Bacteria, Anaerobic
Bacterial Infections
Cohort Studies
Empyema, Pleural
Exudates and Transudates
Female
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Humans
Male
Middle Aged
Multiplex Polymerase Chain Reaction
Pleural Effusion
Prospective Studies
English
BACKGROUND
The identification of the pathogens in pleural effusion has mainly relied on conventional bacterial culture or single species polymerase chain reaction (PCR), both with relatively low sensitivity. We investigated the efficacy of a commercially available multiplex bacterial PCR assay developed for pneumonia to identify the pathogens involved in pleural infection, particularly empyema.
METHODS
A prospective, monocentric, observational study including 194 patients with pleural effusion. Patients were evaluated based on imaging, laboratory values, pleura ultrasound and results of thoracentesis including conventional microbiology studies during hospitalisation. Multiplex bacterial PCR (Curetis Unyvero p55) was performed in batch and had no influence on therapeutic decisions.
RESULTS
Overall, there were 51/197 cases with transudate and 146/197 with exudate. In 42% (n = 90/214) there was a clinical suspicion of parapneumonic effusion and the final clinical diagnosis of empyema was made in 29% (n = 61/214) of all cases. The most common microorganisms identified in the cases diagnosed with empyema were anaerobes [31] followed by gram-positive cocci [10] and gram-negative rods [4]. The multiplex PCR assay identified more of the pathogens on the panel than the conventional methods (23.3% (7/30) vs. 6.7% (2/30), p = 0.008).
CONCLUSION
The multiplex PCR-based assay had a higher sensitivity and specificity than conventional microbiology when only the pathogens on the pneumonia panel were taken into account. A dedicated pleural empyema multiplex PCR panel including anaerobes would be needed to cover most common pathogens involved in pleural infection.
The identification of the pathogens in pleural effusion has mainly relied on conventional bacterial culture or single species polymerase chain reaction (PCR), both with relatively low sensitivity. We investigated the efficacy of a commercially available multiplex bacterial PCR assay developed for pneumonia to identify the pathogens involved in pleural infection, particularly empyema.
METHODS
A prospective, monocentric, observational study including 194 patients with pleural effusion. Patients were evaluated based on imaging, laboratory values, pleura ultrasound and results of thoracentesis including conventional microbiology studies during hospitalisation. Multiplex bacterial PCR (Curetis Unyvero p55) was performed in batch and had no influence on therapeutic decisions.
RESULTS
Overall, there were 51/197 cases with transudate and 146/197 with exudate. In 42% (n = 90/214) there was a clinical suspicion of parapneumonic effusion and the final clinical diagnosis of empyema was made in 29% (n = 61/214) of all cases. The most common microorganisms identified in the cases diagnosed with empyema were anaerobes [31] followed by gram-positive cocci [10] and gram-negative rods [4]. The multiplex PCR assay identified more of the pathogens on the panel than the conventional methods (23.3% (7/30) vs. 6.7% (2/30), p = 0.008).
CONCLUSION
The multiplex PCR-based assay had a higher sensitivity and specificity than conventional microbiology when only the pathogens on the pneumonia panel were taken into account. A dedicated pleural empyema multiplex PCR panel including anaerobes would be needed to cover most common pathogens involved in pleural infection.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s12879-020-4793-6
- PMID 32007106
- Persistent URL
- https://sonar.ch/global/documents/18306
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