Multiplex PCR of Endotracheal Aspirate for the Detection of Pathogens in Ventilator Associated Pneumonia.

Song, Ju Han; Myung, Soon Chul; Choi, Song Ho; Jeon, Eun Ju; Kang, Hyung Gu; Lee, Hye Min; Cho, Sung Keun; Choi, Jae Chol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui; Kim, Jae Yeol

doi:2008.64.3.194

Tuberc Respir Dis > Volume 64(3); 2008 > Article

Original Article

Tuberculosis and Respiratory Diseases 2008;64(3):194-199.
DOI: https://doi.org/10.4046/trd.2008.64.3.194 Published online March 1, 2008.

Multiplex PCR of Endotracheal Aspirate for the Detection of Pathogens in Ventilator Associated Pneumonia.

Ju Han Song, Soon Chul Myung, Song Ho Choi, Eun Ju Jeon, Hyung Gu Kang, Hye Min Lee, Sung Keun Cho, Jae Chol Choi, Jong Wook Shin, In Won Park, Byoung Whui Choi, Jae Yeol Kim

¹Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. jykimmd@cau.ac.kr
²Department of Urology, College of Medicine, Chung-Ang University, Seoul, Korea.
³Department of Cell Genomics, College of Medicine, Chung-Ang University, Seoul, Korea.

Abstract

BACKGROUND
Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. METHODS: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. RESULTS: Twenty-four patients (M:F=18:6, mean age=70+/-11) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. CONCLUSION: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.

Key Words: Multiplex PCR, Ventilator associated pneumonia, P. aeruginosa, K. pneumoniae, MRSA