Patterns and predictors of positive multiplex polymerase chain reaction respiratory panel among patients with acute respiratory infections in a single center in Lebanon

被引:0
作者
El Zakhem, Aline [1 ]
Mahmoud, Omar [1 ]
Fakhreddine, Hisham Bou [2 ]
Mahfouz, Rami [3 ]
Bouakl, Imad [2 ]
机构
[1] Amer Univ Beirut, Med Ctr, Div Infect Dis, Beirut 110236, Lebanon
[2] Amer Univ Beirut, Med Ctr, Div Pulm & Crit Care, Beirut, Lebanon
[3] Amer Univ Beirut, Med Ctr, Dept Pathol & Lab Med, Beirut, Lebanon
关键词
Molecular diagnosis; Polymerase chain reaction; Respiratory infection; Microbiology; Lebanon; Antibiotic stewardship; COMMUNITY-ACQUIRED PNEUMONIA; VIRAL-INFECTION; ETIOLOGY; RHINOVIRUS; ADULTS; BACTERIA; TRACT; EPIDEMIOLOGY; ANTIBIOTICS; PREVALENCE;
D O I
10.1007/s11033-023-09133-6
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
BackgroundInfectious agents associated with community-acquired acute respiratory infections (ARIs) remain understudied in Lebanon. We aim to assess the microbiological profiles of ARIs by employing polymerase chain reaction (PCR) and identifying predictors of positive PCR results among patients admitted for ARI. Methods and resultsWe conducted a retrospective single-center study at the American University of Beirut Medical Center, including all respiratory PCR panels performed on pediatric (< 18) and adult (>= 18) patients presenting with an ARI from January 2015 to March 2018, prior to the onset of the COVID-19 pandemic. We aimed to identify the epidemiological patterns of ARIs and the factors associated with positive PCRs in both adult and pediatric patients. Among 281 respiratory PCRs, 168 (59.7%) were positive for at least one pathogen, with 54.1% positive PCR for viruses, 7.8% for bacteria species, and 3.9% with virus-bacteria codetection. Almost 60% of the patients received antibiotics prior to PCR testing. PCR panels yielded more positive results in pediatric patients than in adults (P = 0.005). Bacterial detection was more common in adults compared to pediatrics (P < 0.001). The most common organism recovered in the entire population was Human Rhinovirus (RhV) (18.5%). Patients with pleural effusion on chest CT were less likely to have a positive PCR (95% Cl: 0.22-0.99). On multivariate analysis, pediatric age group (P < 0.001), stem cell transplant (P = 0.006), fever (P = 0.03) and UTRI symptoms (P = 0.004) were all predictive of a positive viral PCR. ConclusionUnderstanding the local epidemiology of ARI is crucial for proper antimicrobial stewardship. The identification of factors associated with positive respiratory PCR enhances our understanding of clinical characteristics and potential predictors of viral detection in our population.
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