Abstract
Background: Lower respiratory tract infections (LRTI) are a significant cause of morbidity and mortality in lung transplant (LTx) recipients. Timely and precise pathogen detection is vital. Rapid-response multiplex PCR-kits (RM-PCR) offer a valuable diagnostic addition.
Aim: To assess how RM-PCR compares to conventional microbiology and virological tests of LTx recipients.
Methods: A prospective observational cohort study in 60 LTx recipients with suspected LRTI was performed. All patients received RM-PCR testing of bronchoalveolar lavage fluid in addition to conventional tests including microbiological cultures and immunofluorescence testing (IFT) ± conventional PCR for respiratory viruses. Primary outcome was time to test result; secondary outcomes included time-to-treatment modification and test accuracy of RM-PCR.
Results: RM-PCR provided results significantly faster than conventional tests (2.3h vs 23.4h, P<.001), allowing for faster clinical decisions (2.3h vs virology 24.2h and microbiology 29.4h, P<.001). Based on all diagnostic modalities, 26 patients were diagnosed with viral LRTI, 9 with non-viral LRTI and 5 with combined viral and non-viral LRTI. These diagnoses could be established by RM-PCR in 92%, 78% and 100%, respectively. The remaining 20 patients received an alternative diagnosis. Preliminary therapies established based on RM-PCR results were upheld in 90%. There were 6 treatment modifications based on pathogen-isolation by conventional testing missed by RM-PCR (fungal n=3).
Conclusions: RM-PCR offered significantly faster test results compared to conventional tests with overall good concordance.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2857.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021