Skip to main content
  • Meeting abstract
  • Published:

Specific multigenotypic diagnosis of nosocomial pneumonia in ICU

Mortality rate of nosocomial pneumonia in ventilated ICU patients (pts) is about 20-25%. Despite advances in critical care, standard criteria for pneumonia are still inaccurate. Antibiotherapy is often started on a 'best guess' basis to anticipate frequently negative bacteriological results (Ba-cul). Main etiological pathogens are staphylococci, streptococci, pseudomonads and enterobacteriaceae. A multigenotypic and sequential molecular identification (Mol-id) was applied on bronchoalveolar lavages (BAL) from 12 pts with clinical-radiological evidence of infection with (n = 9)/without (n = 3) positive Ba-cul. DNA extraction and duplicate specific amplification of 16S rDNA from BAL was first used to identify signals corresponding to the presence of Gram + (G+), Gram - (G-), or mixed G+/G-. Any G+ signal was followed by femA and mecA multiplex (mpx)-PCR for species-specific identification of staphylococci and methicillin resistance, and by mpx-PCR for S. pneumoniae. Any G- signal was followed by mpx-PCR for species-specific identification of Pseudomonads (aeruginosa, cepacia, maltophilia) vs other G- for which the 16S rDNA amplicon was sequenced.

Mol-id identified mixed G+/G- in 2/3 negative Ba-cul. Ba-cul gave G+ or G- only in 3 and 4/12 pts, respectively. Among these, Mol-id confirmed either G+ (2/3) or G- (2/4), and found a mixed signal in 3/7 pts. Mixed G+/G- was found by Ba-cul and Mol-id in 2/12 BAL, but in one case, S. epidermidis was found by Mol-id and enterococci by Ba-cul. Staphylococci (MRSA, other) and Ps. aeruginosa were found by Ba-cul and Mol-id in 2 and 3 pts, respectively.

Current results suggest that Mol-id is a useful adjunct bringing more insight to standard criteria of nosocomial pneumoniae in ICU and can be a timely relevant guide for antibiotherapy.

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Pirard, M., Laterre, PF., Bouyer, M. et al. Specific multigenotypic diagnosis of nosocomial pneumonia in ICU. Crit Care 5 (Suppl 1), P047 (2001).

Download citation

  • Received:

  • Published:

  • DOI: