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Point‐of‐Care Testing by Multiplex‐PCR in Different Compartments in Suspected Lower Respiratory Tract Infection After Lung Transplantation—Results of a Prospective Study

Year: 2025

Type: article

Abstract: BACKGROUND: Respiratory tract infections (RTIs) are a leading cause of morbidity and mortality following lung transplantation (LTx). This study evaluated a point-of-care multiplex-PCR testing system (POCTmPCR) for pathogen detection in various respiratory samples from LTx recipients. METHODS: In a prospective single-center study, LTx recipients with RTI undergoing bronchoscopy were enrolled. Samples from bronchoalveolar lavage (BAL), sputum, and nasopharyngeal swabs (NPS) were analyzed by POCTmPCR in conjunction with conventional diagnostics. The primary study endpoint was the concordance of POCTmPCR results between samples (DRKS00032359). RESULTS: Fifty participants with a median age of 48 years were included; 28 (56%) were previously colonized. Using POCTmPCR, 44 bacterial pathogens were identified in BAL from 30 patients, 49 in sputum (30 patients), and 33 in NPS (17 patients). POCTmPCR identified 24 viral pathogens in BAL from 20 patients, 22 pathogens in sputum of 19 patients, and 19 in NPS of 19 patients. For viral POCTmPCR, sensitivity and specificity compared to BAL were 84% and 97% in sputum, and 80% and 97% in NPS, respectively. For bacterial POCTmPCR, sensitivity and specificity were 80% and 67% in sputum, and 37% and 85% in NPS, respectively. POCTmPCR in comparison to conventional workup had a sensitivity of 89% and 80% and specificity of 75% and 76% for viral and bacterial pathogens, respectively. CONCLUSION: POCTmPCR in nasal swabs and sputum may serve as an alternative to BAL for detecting respiratory viruses. Performance for bacterial detection in noninvasive samples was lower. The POCTmPCR system used lacks detection for SARS-CoV-2 and Aspergillus spp.

Source: Transplant Infectious Disease

DOI: 10.1111/tid.70036

Authors: Susanne Simon, Merle Sophie Kaiser, Marcus Bachmann, Gérard Krause, Jens Gottlieb

Institutions: Medizinische Hochschule Hannover, German Center for Infection Research, Helmholtz Centre for Infection Research, Center for Experimental and Clinical Infection Research, German Center for Lung Research

Language: English

Topic: Bacterial Identification and Susceptibility Testing

Subfield: Clinical Biochemistry

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,920