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. 2024 Nov 5:17:4843-4852.
doi: 10.2147/IDR.S483256. eCollection 2024.

The Clinical Application Value of a Novel Chip in the Detection of Pathogens in Adult Pneumonia: A Multi-Centre Prospective Study in China

Ruixue Zhang  1 , Hui Xu  1 , Xiaoxue Zhang  1 , Hui Xiong  2 , Fei Tang  3 , Liping Lv  3 , Xiangdong Mu  4 , Wei Tian  5 , Yueguang Cheng  6 , JianRong Lu  6 , Xiuhong Nie  7 , Yang Guo  8 , Yingying Liu  9 , Zhi Zhang  10 , Lianjun Lin  1
Affiliations

The Clinical Application Value of a Novel Chip in the Detection of Pathogens in Adult Pneumonia: A Multi-Centre Prospective Study in China

Ruixue Zhang et al. Infect Drug Resist. .

Abstract

Purpose: The detection of pathogenic microorganisms plays a significant role in the diagnosis and management of pneumonia that are responsible for a substantial number of deaths worldwide. However, conventional microbiological tests (CMT) have low accuracy and are time-consuming. In this study, we aim to evaluate the clinical value of Chips for Complicated Infection Detection (CCID) in detecting pneumonia pathogens.

Patients and methods: This study was conducted at nine hospitals in China from January 2021 to September 2022. Respiratory samples from adult pneumonia patients were collected from each patient. CMT and CCID were performed in parallel to identify the pathogens.

Results: A total of 245 patients were included, with 73% being elderly. CCID identified pathogenic microbes in 78.0% of patients and conventional microbiological tests (CMT) in 57.1% of the patients (p<0.001). The overall positive and negative percent agreements between CCID and CMT for pathogen detection were 90.07% and 38.46%, respectively. 38.8% of patients were diagnosed with mixed infections with at least two pathogens by CCID. Bacterial infections identified by CCID accounted for 60.0% of 245 patients, with the top 3 being Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecium, respectively. K. pneumoniae was the most common pathogen in elderly patients, with a significantly higher prevalence compared to non-elderly patients (p = 0.0011). Among the 197 patients who had used antibiotics before sample collection, the positive rate of CCID was significantly higher than that of CMT (p < 0.001).

Conclusion: This study indicates that compared to CMT, this novel chip has significant advantages in detecting pathogens in pneumonia patients, especially in the elderly.

Keywords: LAMP; chip; elderly; pathogens; pneumonia.

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Conflict of interest statement

The authors report there are no competing interests to declare.

Figures

Figure 1
Figure 1
Workflow of CCID detection. This figure was created with the aid of Biorender (https://biorender. com/).
Figure 2
Figure 2
Flow chart of this study.
Figure 3
Figure 3
Concordance of diagnosis between CCID and CMT. (A) Contingency table for CCID and CMT. PPA: positive percentage agreement, NPA: negative percentage agreement. (B) The results of CCID and CMT were positive in 127 (51.84%) cases. Among the double-positive cases, 20 (8%) were matched and 65 (26%) were partly-matched. (C and D) Composition of pathogens in patients with CCID results.
Figure 4
Figure 4
Overlap of common bacteria detected by CCIID and CMT. Detection efficiency of CCID and CMT for different bacteria.
Figure 5
Figure 5
Pathogen analysis in the subgroups and effect of antibiotic exposure on pathogen detection. (A) Different pathogenic organisms between sputum and BALF samples. (B) Positive numbers of CCID and CMTs in BALF and sputum samples. (C) Pathogen analysis detected by CCID in elderly and non-elderly. (D) CCID positivity and CMT positivity in samples with prior antibiotic exposure. ns, no significant difference; ***, p ˂ 0.001.
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