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Messous S, Elargoubi A, Pillet S, Rajoharison A, Hoffmann J, Trabelsi I, Grissa MH, Boukef R, Beltaief K, Mastouri M, Paranhos-Baccalà G, Nouira S, Pozzetto B. Bacterial and Viral Infection in Patients Hospitalized for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Implication for Antimicrobial Management and Clinical Outcome. COPD 2020; 18:53-61. [PMID: 33353408 DOI: 10.1080/15412555.2020.1854210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) exhibit frequent acute exacerbations (AE). The objectives of this study were first to evaluate the prevalence of pathogens associated to these episodes by combining conventional bacteriology and multiplex viral and bacterial PCR assays in sputum specimens, and second to determine whether C-reactive protein (CRP) value and clinical outcome could be influenced by the type of microbial agent(s) recovered from these samples. A cohort of 84 Tunisian patients hospitalized at the emergency room for AECOPD was investigated prospectively for the semi-quantitative detection of bacteria by conventional culture (the threshold of positivity was of 107 CFU/ml) and for the detection of viral genome and DNA of atypical bacteria by quantitative PCR using two commercial multiplex respiratory kits (Seegene and Fast-track). The two kits exhibited very similar performances although the Seegene assay was a bit more sensitive. A large number and variety of pathogens were recovered from the sputum samples of these 84 patients, including 15 conventional bacteria, one Chlamydia pneumoniae and 63 respiratory viruses, the most prevalent being rhinoviruses (n = 33) and influenza viruses (n = 13). From complete results available for 74 patients, the presence of bacteria was significantly associated with risk of recurrence at 6 and 12 months post-infection. The combination of these different markers appears useful for delineating correctly the antimicrobial treatment and for initiating a long-term surveillance in those patients with high risk of recurrent exacerbation episodes. A prospective study is required for confirming the benefits of this strategy aimed at improving the stewardship of antibiotics.
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Affiliation(s)
- Salma Messous
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Aida Elargoubi
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Sylvie Pillet
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
| | - Alain Rajoharison
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Jonathan Hoffmann
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Imen Trabelsi
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia
| | - Mohamed Habib Grissa
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Riadh Boukef
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Sahloul University Hospital, Sousse, Tunisia
| | - Kaouther Beltaief
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Maha Mastouri
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | | | - Semir Nouira
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Bruno Pozzetto
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
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Aydemir O, Aydemir Y, Ozdemir M. The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections. Pak J Med Sci 2014; 30:1011-6. [PMID: 25225517 PMCID: PMC4163223 DOI: 10.12669/pjms.305.5098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 06/09/2014] [Accepted: 06/12/2014] [Indexed: 11/30/2022] Open
Abstract
Objectives: Lower respiratory tract infection is one of the most important causes of morbidity and mortality. However establishing a microbial diagnosis for patients with lower respiratory tract infection is still challenging and is often achieved in only half of cases by conventional methods. This study was designed to compare the fast responsive PCR method with the culture method in lower respiratory tract infections and to evaluate the reliability of multiplex PCR method. Methods: One hundred ninety seven patients with the symptoms of acute lower respiratory tract infection, and diagnosed with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and exacerbations of bronchiectasis were included in the study. Both culture and PCR methods was performed for the isolation of most commonly seen bacteria, from sputum, nasopharyngeal swabs and bronchoalveolar lavage fluid samples. Results: While at least one bacterial isolation was determined in 62 (31.5%) of all patients with culture method, this number increased to 125 (63.5%) with multiplex PCR. The bacteria most commonly identified by PCR were S. pneumoniae (32%) and H. influenzae (31%). There was a significant difference between PCR and culture in terms of multi-factor detection rates (p<0.005). Multiple bacteria were detected in only two cases in cultures; however, multiple pathogens were detected in 47 cases with PCR. Conclusions: Conventional methods, such as culture and serology are not always adequate to detect the pathogens in lower respiratory tract. Real-time PCR assays proved highly sensitive and rapid. The prevalence of bacteria and multiple agent detected by real-time PCR compared with culture was substantially higher. Widespread use of PCR methods, by providing the immediate and appropriate ''agent specific antibiotic treatment'' of LRTI, will help reduce failure and contributes to a reduction in antibiotic resistance.
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Affiliation(s)
- Ozlem Aydemir
- Ozlem Aydemir, Department of Microbiology, Sakarya University, Training and Research Hospital, Sakarya, Turkey
| | - Yusuf Aydemir
- Yusuf Aydemir, Department of Pulmonology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Ozdemir
- Mehmet Ozdemir, Faculty of Medicine, Department of Microbiology, Necmettin Erbakan University, Konya, Turkey
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