Alsó légúti minták molekuláris mikrobiológiai vizsgálata a koronavírus-járvány idoszakában.

ABSTRACT

INTRODUCTION: BioFire FilmArray Pneumonia plus Panel (bioMérieux) is a PCR method for microbiological diagnostics of lower respiratory infections. It can detect 18 bacteria, 9 viruses and 7 antibiotic resistance genes in real time. It can help the differential diagnosis and the choice of therapy of pneumonia, by giving results in two hours. OBJECTIVE: Reviewing the results of pneumonia PCR tests performed in our laboratory, and comparing them with the results of conventional culturing. METHOD: From October 2020 to September 2021, 820 lower respiratory tract samples were analyzed from inpatients with suspected pneumonia. Beside the PCR test, culturing was also performed. Oropharyngeal swabs were used for supplementary SARS-CoV-2 PCR. RESULTS: 40% of samples were collected from SARS-CoV-2-positive patients. In 60% of the samples, the PCR test detected pathogens or resistance genes. The most commonly detected pathogens were Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. 44% of the bacteria detected by PCR were not verified by culturing, whereas by culturing, several other bacteria, fungi and antibiotic resistance mechanisms were detected, which were not shown in the results of the multiplex PCR tests. In SARS-CoV-2-positive inpatients, 25.8% of the detected bacteria was S. aureus. The most common resistance gene was mecA/C (MRSA). In this group, other respiratory virus genes were detected in 2% of SARS-CoV-2-positive patients, whereas in 13% in samples of SARS-CoV-2-negative patients. CONCLUSIONS: Because of the importance of pathogens excluded from the PCR targets and multifactorial mechanisms of antibiotic resistance, culturing is recommended to perform beside pneumonia-specific multiplex PCR tests. Orv Hetil. 2022; 163(33) 1295-1302.