Publication Type : Journal Article
Thematic Areas : Medical Sciences
Publisher : J Crit Care
Source : J Crit Care, Volume 33, p.274 (2016)
Url : http://www.ncbi.nlm.nih.gov/pubmed/26987262
Keywords : A. V Kumar, “Comments on "Impact of bronchoalveolar lavage multiplex polymerase chain reaction on microbiological yield and therapeutic decisions in severe pneumonia in intensive care unit".”, J Crit Care, vol. 33, p. 274, 2016.
Campus : Kochi
School : School of Medicine
Department : Microbiology
Year : 2016
Abstract : Purpose: The purpose of the study is to evaluate the impact of adding bronchoalveolar lavage multiplex polymerase chain reaction (M-PCR) to conventional cultures (CC) on microbiological yield and therapeutic decisions in adult intensive care unit patients with pneumonia and severe sepsis or septic shock.
Material and methods: In this retrospective case-control study, bronchoalveolar lavage cultures were taken for control (58 patients, 58 admissions) and study arms (57 patients, 58 admissions). Bronchoalveolar lavage M-PCR was sent simultaneously for the latter.
Results: A total of 267 microorganisms were identified (M-PCR alone, 211; CC alone, 15; both, 41) in the study arm vs 64 in controls. Concordance between M-PCR and culture was complete in 32 (55.17%), partial in 4 (6.9%), and discordant in 22 (37.93%) including 17 with positive M-PCR but negative CC. Time to antibiotic therapy modification was significantly less (P < .001) in M-PCR group compared to controls (32.40 ± 14.41 vs 41.74 ± 45.61 hours). There was no significant difference in index episode resolution (48.3% vs 50%; P = 1), intensive care unit mortality (57.4% vs 51.2%; P = .67), and hospital mortality (59.6% vs 61.5%; P = 1) in study and control arms, respectively, despite more septic shock patients in the study arm (89.7% vs 75.9%; P = .05).
Conclusion: Bronchoalveolar lavage M-PCR with culture leads to higher microbiological yield and earlier modification of antibiotics compared to conventional culture.
Cite this Research Publication : Bronchoalveolar Lavage, Humans, Intensive care units, Multiplex Polymerase Chain Reaction, pneumonia, polymerase chain reaction