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Review
. 2024 Jan 18;13(1):95.
doi: 10.3390/antibiotics13010095.

Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia

Julien Dessajan  1 , Jean-François Timsit  1   2
Affiliations
Review

Impact of Multiplex PCR in the Therapeutic Management of Severe Bacterial Pneumonia

Julien Dessajan et al. Antibiotics (Basel). .

Abstract

Pneumonia is a common and severe illness that requires prompt and effective management. Advanced, rapid, and accurate tools are needed to diagnose patients with severe bacterial pneumonia, and to rapidly select appropriate antimicrobial therapy, which must be initiated within the first few hours of care. Two multiplex molecular tests, Unyvero HPN and FilmArray Pneumonia+ Panel, have been developed using the multiplex polymerase chain reaction (mPCR) technique to rapidly identify pathogens and their main antibiotic resistance mechanisms from patient respiratory specimens. Performance evaluation of these tests showed strong correlations with reference techniques. However, good knowledge of their indications, targets, and limitations is essential. Collaboration with microbiologists is, therefore, crucial for their appropriate use. Under these conditions, and with standardized management, these rapid tests can improve the therapeutic management of severe pneumonia faster, more precisely, and with narrow-spectrum antibiotic therapy. Further randomized controlled trials are needed to address the many unanswered questions about multiplex rapid molecular testing during the diagnosis and the management of severe pneumonia. This narrative review will address the current knowledge, advantages, and disadvantages of these tests, and propose solutions for their routine use.

Keywords: ICU; diagnosis; nosocomial pneumonia; rapid tests; resistance; sepsis.

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Conflict of interest statement

J.-F.T. reports lectures for bioMérieux and Qiagen. He is the PI of MULTICAP RCT funded by the French ministry of health. No other conflict of interest with this article.

Figures

Figure 1
Figure 1
Proposed decision algorithm that integrates mPCR results in the choice of empirical therapy in HAP and VAP. AB: antibiotic, GPC: Gram positive cocci, GNB: Gram negative bacilli, mPCR: multiplex polymerase chain reaction, LNZ: linezolid, Peni: Penicillin, MRSA: methicillin-resistant Staphylococcus aureus, VAP: ventilatory-associated pneumonia, NF GNB: non fermentative Gram-negative bacilli, Carb: carbapenem, OXA and NDM: carbapenemases gene. 3GC: third generation cephalosporins.
See this image and copyright information in PMC

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