Affordable Access

Access to the full text

Pleurale Infektionen: Die Rolle der Multiplex-PCR in der Erregerdiagnostik einordnen

Authors
  • Keymel, Stefanie
Type
Published Article
Journal
Kompass Pneumologie
Publisher
S. Karger GmbH
Publication Date
Aug 18, 2020
Volume
8
Issue
5
Pages
256–258
Identifiers
DOI: 10.1159/000510785
Source
Karger
Keywords
License
Green
External links

Abstract

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 [<xref ref-type="bibr" rid="ref31">31</xref>] followed by gram-positive cocci [<xref ref-type="bibr" rid="ref10">10</xref>] and gram-negative rods [<xref ref-type="bibr" rid="ref4">4</xref>]. 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.

Report this publication

Statistics

Seen <100 times