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Published online before print May 31, 2006
Eur Respir J 2006, doi:10.1183/09031936.06.00006106
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ORIGINAL ARTICLE

Evaluation of a multiplex PCR for bacterial pathogens applied to bronchoalveolar lavage

K. Strålin 1*, J. Korsgaard 2, P. Olcén 3

1 Depts of Infectious Diseases and
2 Dept of Chest Diseases, Aarhus University Hospital, Aalborg, Denmark
3 Clinical Microbiology, Örebro University Hospital, Örebro, Sweden

* To whom correspondence should be addressed. E-mail: kristoffer.stralin{at}orebroll.se.


  Abstract

The present study assessed the diagnostic usefulness of a multiplex PCR (mPCR) for Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydophila pneumoniae applied to bronchoalveolar lavage (BAL).

Fibre optic bronchoscopy was performed on 156 hospitalized adult patients with lower respiratory tract infection (LRTI) and 36 controls. BAL fluid was analysed with bacterial culture and mPCR.

By conventional diagnostic methods, S. pneumoniae, H. influenzae, M. pneumoniae, and C. pneumoniae were aetiological agents in 14%, 21%, 3.2%, and 0, of the LRTI patients, respectively. These pathogens were identified by BAL mPCR in 28%, 47%, 3.2%, and 0.6%, yielding sensitivities of 86% for S. pneumoniae, 88% for H. influenzae, 100% for M. pneumoniae, and 0% for C. pneumoniae, and specificities of 81% for S. pneumoniae, 64% for H. influenzae, 100% for M. pneumoniae, and 99% for C. pneumoniae. In 103 patients with antibiotics taken prior to bronchoscopy, S. pneumoniae was identified by culture in 2.9% and by mPCR in 31%. Among the controls, mPCR identified S. pneumoniae in 11% and H. influenzae in 39%.

In LRTI patients, BAL mPCR can be useful for identification of S. pneumoniae, M. pneumoniae, and C. pneumoniae. The method appears particularly useful in patients treated with antibiotics.

Keywords:  Bronchoalveolar lavage, Haemophilus influenzae, lower respiratory tract infection, Mycoplasma pneumoniae, PCR, Streptococcus pneumoniae




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