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Concordance between a new molecular real-time approach and traditional culture in suspected VAP patients
Critical Care volume 19, Article number: P107 (2015)
Early microbiological documentation may reduce attributable mortality and excessive use of broad-spectrum antibiotics in ventilator-associated pneumonia (VAP). Using bronchoalveolar lavage (BAL) and endotracheal aspirates (ETA), we studied a new molecular biology-based approach to detect and quantify bacteria in less than 3 hours. This prospective multicenter trial aimed at comparing the microbiological results obtained using this molecular protocol (easyMAG® system) and semiquantitative culture in suspected VAP.
ETA and BAL samples were consecutively collected during 10 months in adult patients in four ICUs of France. The molecular method includes a preprocessing liquefaction for ETA before DNA extraction. DNAs were extracted using the easyMAG® system. Real-time PCR (qPCR) was run using the ABI7500FastDx PCR instrument. The results presented here concern: Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacteriaceae. Quantification was performed using qPCR standard curves, by converting the cycle threshold to CFU/ ml.
A total of 125 suspected VAP were included from 122 patients. In total, 125 BAL and 107 ETA were collected. Sex ratio (M/F) was 76%, and CPIS ≥6 was calculated in 74.6% of the suspected VAP patients. Mean ventilation duration before sampling was 6 days. Seventy-eight percent and 65% of the BAL and ETA culture were positive respectively. Correlations between molecular method and culture on BAL and ETA are reported in Table 1.
Sensitivity and specificity of the new molecular approach for these main bacteria found in VAP could enable targeted first-line antibiotic therapy. In the future, the development of this approach will aim at obtaining a bedside diagnostic in only a few hours.
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Clavel, M., Barraud, O., Moucadel, V. et al. Concordance between a new molecular real-time approach and traditional culture in suspected VAP patients. Crit Care 19, P107 (2015). https://doi.org/10.1186/cc14187
- Pseudomonas Aeruginosa
- Molecular Method
- Microbiological Result
- Attributable Mortality
- Prospective Multicenter Trial