PT - JOURNAL ARTICLE AU - Anna Salina AU - Desiree M. Schumann AU - Léo Franchetti AU - Kathleen Jahn AU - Kurosch Purkabiri AU - Raphael Müller AU - Werner Strobel AU - Nina Khanna AU - Michael Tamm AU - Daiana Stolz TI - Multiplex bacterial PCR in the bronchoalveolar lavage fluid of non-intubated patients with suspected pulmonary infection: a quasi-experimental study AID - 10.1183/23120541.00595-2021 DP - 2022 Apr 01 TA - ERJ Open Research PG - 00595-2021 VI - 8 IP - 2 4099 - http://openres.ersjournals.com/content/8/2/00595-2021.short 4100 - http://openres.ersjournals.com/content/8/2/00595-2021.full SO - erjor2022 Apr 01; 8 AB - Background Early pathogen identification in pulmonary infection is crucial to guide antibacterial therapy and decrease length of hospital stay. We hypothesise that compared to conventional diagnostic methods, a multiplex bacterial polymerase chain reaction assay has a higher diagnostic yield in bronchoalveolar lavage (BAL) fluid and improved clinical outcomes in patients with suspicion of pulmonary infection.Methods A prospective, monocentric, quasi-experimental, observational study was carried out. Unselected patients with suspected pulmonary infection who underwent bronchoscopy with BAL were included in the study over a period of 1 year. In addition to conventional diagnostic methods, a multiplex PCR bacterial assay was performed in BAL on a 2 week on: 1 week off pre-determined schedule. No therapeutic recommendations were provided to the treating physician.Results 605 cases were included, 54% of whom were immunosuppressed. Conventional diagnostic methods detected 56% of the bacteria evidenced by PCR. PCR failed to detect bacteria in 4% of the cases with a positive conventional diagnostic result. After bronchoscopy, 42% of the patients received antibacterial therapy for pulmonary infection for a median of 12 antibiotic days. There was no statistically significant difference in length of hospital stay (median 8 versus 8; p=0.839), antibiotic exposure (median 11 versus 14; p=0.362) or number of antibiotics prescribed (median 2 versus 2; p=0.595) between the two groups.Conclusions A multiplex bacterial PCR detected more bacteria in BAL fluid than conventional diagnostic methods. However, without a specific antibiotic stewardship approach and a clear understanding of the clinical implications of a positive or negative PCR result, the PCR results did not influence clinical outcomes.A multiplex bacterial PCR detects more bacteria in BAL fluid than conventional diagnostic methods; however, without a specific antibiotic stewardship approach, PCR results do not influence clinical outcomes https://bit.ly/3L0nd0U