16S pan-bacterial PCR can accurately identify patients with ventilator-associated pneumonia

Andrew Conway Morris, Naomi Gadsby, James P McKenna, Thomas P Hellyer, Paul Dark, Suveer Singh, Timothy S Walsh, Danny F McAuley, Kate Templeton, A John Simpson, Ronan McMullan

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)
185 Downloads (Pure)

Abstract

Ventilator-associated pneumonia (VAP) remains a challenge to intensive care units, with secure diagnosis relying on microbiological cultures that take up to 72 hours to provide a result. We sought to derive and validate a novel, real-time 16S rRNA gene PCR for rapid exclusion of VAP. Bronchoalveolar lavage (BAL) was obtained from two independent cohorts of patients with suspected VAP. Patients were recruited in a 2-centre derivation cohort and a 12-centre confirmation cohort. Confirmed VAP was defined as growth of >10(4) colony forming units/ml on semiquantitative culture and compared with a 16S PCR assay. Samples were tested from 67 patients in the derivation cohort, 10 (15%) of whom had confirmed VAP. Using cycles to cross threshold (Ct) values as the result of the 16S PCR test, the area under the receiver operating characteristic (ROC) curve (AUROC) was 0.94 (95% CI 0.86 to 1.0, p<0.0001). Samples from 92 patients were available from the confirmation cohort, 26 (28%) of whom had confirmed VAP. The AUROC for Ct in this cohort was 0.89 (95% CI 0.83 to 0.95, p<0.0001). This study has derived and assessed the diagnostic accuracy of a novel application for 16S PCR. This suggests that 16S PCR in BAL could be used as a rapid test in suspected VAP and may allow better stewardship of antibiotics.


Original languageEnglish
Pages (from-to)1046-1048
Number of pages3
JournalThorax
Volume72
Issue number11
Early online date14 Dec 2016
DOIs
Publication statusPublished - Nov 2017
Externally publishedYes

Bibliographical note

As a senior author, my contribution to conception, design and producing the manuscript was substantial. It has received 17 citations during the 4 years since publication and an Altimetric attention score placing it in the top 25% of research outputs.

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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