Respiratory Multiplex Polymerase Chain Reaction: An Important Diagnostic Tool in Immunocompromised Patients
Identifieur interne : 000371 ( Pmc/Checkpoint ); précédent : 000370; suivant : 000372Respiratory 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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<author><name sortKey="Kumar, Navin" sort="Kumar, Navin" uniqKey="Kumar N" first="Navin" last="Kumar">Navin Kumar</name>
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<author><name sortKey="Mehta, Yatin" sort="Mehta, Yatin" uniqKey="Mehta Y" first="Yatin" last="Mehta">Yatin Mehta</name>
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<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>
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<wicri:noRegion>Haryana</wicri:noRegion>
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<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>
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<author><name sortKey="Sengupta, Sharmila" sort="Sengupta, Sharmila" uniqKey="Sengupta S" first="Sharmila" last="Sengupta">Sharmila Sengupta</name>
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<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>
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<series><title level="j">Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine</title>
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<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>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Crit Care Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Indian J Crit Care Med</journal-id>
<journal-id journal-id-type="publisher-id">IJCCM</journal-id>
<journal-title-group><journal-title>Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">0972-5229</issn>
<issn pub-type="epub">1998-359X</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28515602</article-id>
<article-id pub-id-type="pmc">5416785</article-id>
<article-id pub-id-type="publisher-id">IJCCM-21-192</article-id>
<article-id pub-id-type="doi">10.4103/ijccm.IJCCM_2_17</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Respiratory Multiplex Polymerase Chain Reaction: An Important Diagnostic Tool in Immunocompromised Patients</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Kaur</surname>
<given-names>Amarjeet</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kumar</surname>
<given-names>Navin</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sengupta</surname>
<given-names>Sharmila</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mehta</surname>
<given-names>Yatin</given-names>
</name>
<xref ref-type="aff" rid="aff2">1</xref>
</contrib>
</contrib-group>
<aff id="aff1">Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana, India</aff>
<aff id="aff2"><label>1</label>
Department of Critical Care and Anaesthesiology, Medanta - The Medicity, Gurgaon, Haryana, India</aff>
<author-notes><corresp id="cor1"><bold>Address for correspondence:</bold>
Dr. Amarjeet Kaur, Department of Microbiology, Medanta - The Medicity, Gurgaon, Haryana, India. E-mail: <email xlink:href="amar.k.kanjan@gmail.com">amar.k.kanjan@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>4</month>
<year>2017</year>
</pub-date>
<volume>21</volume>
<issue>4</issue>
<fpage>192</fpage>
<lpage>198</lpage>
<permissions><copyright-statement>Copyright: © 2017 Indian Journal of Critical Care Medicine</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.</license-p>
</license>
</permissions>
<abstract><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>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Cytomegalovirus</kwd>
<kwd>immunocompromised patients</kwd>
<kwd>multiplex polymerase chain reaction</kwd>
<kwd><italic>Pneumocystis jirovecii</italic>
</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<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>
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