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Usefulness of real time-polymerase chain reaction (RT-PCR) in the diagnosis of ICU-acquired pneumonia (ICUAP)

Adrian Ceccato, Catia Cilloniz, Miquel Ferrer, Gian Luigi Li Bassi, Laia Fernandez Barat, Tarek Senussi Testa, Mariano Rinaudo, Mariano Esperatti, Francesco Idone, Antoni Torres
European Respiratory Journal 2016 48: PA2634; DOI: 10.1183/13993003.congress-2016.PA2634
Adrian Ceccato
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
3Seccion Pneumonologia, Hospital Nacional Prof. Alejandro Posadas, Palomar, Argentina
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Catia Cilloniz
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Miquel Ferrer
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Gian Luigi Li Bassi
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
2Ciber de Enfermedades Respiratorias, CIBERES, Barcelona, Spain
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Laia Fernandez Barat
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
2Ciber de Enfermedades Respiratorias, CIBERES, Barcelona, Spain
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Tarek Senussi Testa
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
41Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino-IST, Genova, Italy
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Mariano Rinaudo
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Mariano Esperatti
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Francesco Idone
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
5Department of Anesthesiology and Intensive Care, Hopsital “A. Gemelli”, Catholic University of the Sacred Heart, Roma, Italy
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Antoni Torres
1Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
2Ciber de Enfermedades Respiratorias, CIBERES, Barcelona, Spain
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Abstract

Background: ICUAP is the most frequent nosocomial infection in the ICU. Conventional cultures (CC) require at least 48-72 hours for a definitive result. The aim of this study was to evaluate the diagnostic performance of a new platform based on the amplification of nucleic acids (RT-PCR Unyvero, Curetis), designed to identify the pathogenic bacteria that commonly cause ICUAP.

Methods: 128 samples (110, 86% bronchoalveolar lavage, and 18 (14%) bronchial aspirate) obtained from 64 patients with ICUAP collected between 2011 and 2013 were analyzed by RT-PCR and CC.

Results: Concordance between CC and RT-PCR occurred in 43 (67%) patients (83 samples); 32 (50%) patients had negative results by the two methods, and 11 (17%) cases had the same identification by the two methods. In 4 (6%) patients the RT-PCR test was positive and CC was negative, and in 17 (27%) cases disagreement was observed among both techniques. The pathogen most frequently identified was Pseudomonas aeruginosa, by RT-PCR in 5 (8%) patients and by CC in 10 (15%) patients. Among the 43 patients with concordance, changes in the empirical treatment according to RT-PCR results would have been possible in a short period of time in 39 (91%) patients .

Conclusions: Agreement between RT-PCR and CC was observed in 64% samples from ICUAP. Further analysis will be carried out to determine the cause of disagreement.

Supported by SEPAR grant.

  • Pneumonia
  • Intensive care
  • Infections
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Usefulness of real time-polymerase chain reaction (RT-PCR) in the diagnosis of ICU-acquired pneumonia (ICUAP)
Adrian Ceccato, Catia Cilloniz, Miquel Ferrer, Gian Luigi Li Bassi, Laia Fernandez Barat, Tarek Senussi Testa, Mariano Rinaudo, Mariano Esperatti, Francesco Idone, Antoni Torres
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2634; DOI: 10.1183/13993003.congress-2016.PA2634

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Usefulness of real time-polymerase chain reaction (RT-PCR) in the diagnosis of ICU-acquired pneumonia (ICUAP)
Adrian Ceccato, Catia Cilloniz, Miquel Ferrer, Gian Luigi Li Bassi, Laia Fernandez Barat, Tarek Senussi Testa, Mariano Rinaudo, Mariano Esperatti, Francesco Idone, Antoni Torres
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2634; DOI: 10.1183/13993003.congress-2016.PA2634
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