Respiratory Multiplex Polymerase Chain Reaction: An Important Diagnostic Tool in Immunocompromised Patients
Identifieur interne : 000755 ( Main/Exploration ); précédent : 000754; suivant : 000756Respiratory Multiplex Polymerase Chain Reaction: An Important Diagnostic Tool in Immunocompromised Patients
Auteurs : Amarjeet Kaur [Inde] ; Navin Kumar [Inde] ; Sharmila Sengupta [Inde] ; Yatin Mehta [Inde]Source :
- Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine [ 0972-5229 ] ; 2017.
Abstract
Viruses and atypical pathogens can cause significant respiratory illness in immunocompromised patients. Multiplex polymerase chain reaction (MPCR) has improved the diagnostic yield of pathogens, and it is easier to identify the co-infections also. The present study was done to evaluate the performance of MPCR on bronchoalveolar lavage (BAL) samples in immunocompromised patients.
Atotal of 177 BAL specimens collected over a 19 months period from immunocompromised patients with respiratory illness were analyzed with the MPCR and aerobic culture. Patients were divided into four according to the pathogens. Category V (only viral), Category NV (nonviral, i.e., bacteria and atypical), Category M (mixed, i.e., both viral and nonviral pathogen), and Category UK (unknown etiology).
MPCR identified the causative pathogen in 59.3% of patients while culture could identify only in 37.8% of patients. Most frequent etiological agent was
MPCR is highly sensitive and rapid tool which can be considered in the routine diagnostic algorithm of respiratory illness in immunocompromised patients.
Url:
DOI: 10.4103/ijccm.IJCCM_2_17
PubMed: 28515602
PubMed Central: 5416785
Affiliations:
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The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author><author><name sortKey="Mehta, Yatin" sort="Mehta, Yatin" uniqKey="Mehta Y" first="Yatin" last="Mehta">Yatin Mehta</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Critical Care and Anaesthesiology, Medanta - The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Critical Care and Anaesthesiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28515602</idno><idno type="pmc">5416785</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5416785</idno><idno type="RBID">PMC:5416785</idno><idno type="doi">10.4103/ijccm.IJCCM_2_17</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000592</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000592</idno><idno type="wicri:Area/Pmc/Curation">000592</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000592</idno><idno type="wicri:Area/Pmc/Checkpoint">000173</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000173</idno><idno type="wicri:Area/Ncbi/Merge">000627</idno><idno type="wicri:Area/Ncbi/Curation">000627</idno><idno type="wicri:Area/Ncbi/Checkpoint">000627</idno><idno type="wicri:doubleKey">0972-5229:2017:Kaur A:respiratory:multiplex:polymerase</idno><idno type="wicri:Area/Main/Merge">000757</idno><idno type="wicri:Area/Main/Curation">000755</idno><idno type="wicri:Area/Main/Exploration">000755</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Respiratory Multiplex Polymerase Chain Reaction: An Important Diagnostic Tool in Immunocompromised Patients</title><author><name sortKey="Kaur, Amarjeet" sort="Kaur, Amarjeet" uniqKey="Kaur A" first="Amarjeet" last="Kaur">Amarjeet Kaur</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author><author><name sortKey="Kumar, Navin" sort="Kumar, Navin" uniqKey="Kumar N" first="Navin" last="Kumar">Navin Kumar</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author><author><name sortKey="Sengupta, Sharmila" sort="Sengupta, Sharmila" uniqKey="Sengupta S" first="Sharmila" last="Sengupta">Sharmila Sengupta</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author><author><name sortKey="Mehta, Yatin" sort="Mehta, Yatin" uniqKey="Mehta Y" first="Yatin" last="Mehta">Yatin Mehta</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Critical Care and Anaesthesiology, Medanta - The Medicity, Gurgaon, Haryana, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Critical Care and Anaesthesiology, Medanta - The Medicity, Gurgaon, Haryana</wicri:regionArea><wicri:noRegion>Haryana</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine</title><idno type="ISSN">0972-5229</idno><idno type="eISSN">1998-359X</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>Viruses and atypical pathogens can cause significant respiratory illness in immunocompromised patients. Multiplex polymerase chain reaction (MPCR) has improved the diagnostic yield of pathogens, and it is easier to identify the co-infections also. The present study was done to evaluate the performance of MPCR on bronchoalveolar lavage (BAL) samples in immunocompromised patients.</p></sec><sec id="st2"><title>Methods:</title><p>Atotal of 177 BAL specimens collected over a 19 months period from immunocompromised patients with respiratory illness were analyzed with the MPCR and aerobic culture. Patients were divided into four according to the pathogens. Category V (only viral), Category NV (nonviral, i.e., bacteria and atypical), Category M (mixed, i.e., both viral and nonviral pathogen), and Category UK (unknown etiology).</p></sec><sec id="st3"><title>Results:</title><p>MPCR identified the causative pathogen in 59.3% of patients while culture could identify only in 37.8% of patients. Most frequent etiological agent was <italic>Klebsiella pneumoniae</italic> (32%), followed by cytomegalovirus (21%), and <italic>Pneumocystis jirovecii</italic> (10%). Numbers of patients in each category were Category V (9.6%), Category NV (43.5%), Category M (19.8%), and Category UK (27.1%). Mortality was significantly higher in patients of Category M having mixed infections.</p></sec><sec id="st4"><title>Conclusion:</title><p>MPCR is highly sensitive and rapid tool which can be considered in the routine diagnostic algorithm of respiratory illness in immunocompromised patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Franquet, T" uniqKey="Franquet T">T Franquet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jepson, Sl" uniqKey="Jepson S">SL Jepson</name></author><author><name sortKey="Pakkal, M" uniqKey="Pakkal M">M Pakkal</name></author><author><name sortKey="Bajaj, A" uniqKey="Bajaj A">A Bajaj</name></author><author><name sortKey="Raj, V" uniqKey="Raj V">V Raj</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cereser, L" uniqKey="Cereser L">L Cereser</name></author><author><name sortKey="Zuiani, C" uniqKey="Zuiani C">C 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uniqKey="Battegay M">M Battegay</name></author><author><name sortKey="Trendelenburg, M" uniqKey="Trendelenburg M">M Trendelenburg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnstone, J" uniqKey="Johnstone J">J Johnstone</name></author><author><name sortKey="Majumdar, Sr" uniqKey="Majumdar S">SR Majumdar</name></author><author><name sortKey="Fox, Jd" uniqKey="Fox J">JD Fox</name></author><author><name sortKey="Marrie, Tj" uniqKey="Marrie T">TJ Marrie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johansson, N" uniqKey="Johansson N">N Johansson</name></author><author><name sortKey="Kalin, M" uniqKey="Kalin M">M Kalin</name></author><author><name sortKey="Hedlund, J" uniqKey="Hedlund J">J Hedlund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Choi, Sh" uniqKey="Choi S">SH Choi</name></author><author><name sortKey="Hong, Sb" uniqKey="Hong S">SB Hong</name></author><author><name sortKey="Ko, Gb" uniqKey="Ko G">GB Ko</name></author><author><name sortKey="Lee, Y" uniqKey="Lee Y">Y Lee</name></author><author><name sortKey="Park, Hj" uniqKey="Park H">HJ Park</name></author><author><name sortKey="Park, Sy" uniqKey="Park S">SY Park</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Kaur, Amarjeet" sort="Kaur, Amarjeet" uniqKey="Kaur A" first="Amarjeet" last="Kaur">Amarjeet Kaur</name></noRegion><name sortKey="Kumar, Navin" sort="Kumar, Navin" uniqKey="Kumar N" first="Navin" last="Kumar">Navin Kumar</name><name sortKey="Mehta, Yatin" sort="Mehta, Yatin" uniqKey="Mehta Y" first="Yatin" last="Mehta">Yatin Mehta</name><name sortKey="Sengupta, Sharmila" sort="Sengupta, Sharmila" uniqKey="Sengupta S" first="Sharmila" last="Sengupta">Sharmila Sengupta</name></country></tree></affiliations></record>Pour manipuler 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