BACKGROUND: We aim to evaluate the efficacy of polymerase chain reaction (PCR) to detect Acinetobacter baumannii in endotracheal aspirates. METHODS: Endotracheal aspirates and clinical data were collected from patients who were admitted to the intensive care unit of Taipei Veterans General Hospital between April 1 and August 31 in 2006. Bacterial isolates from endotracheal aspirate cultures were phenotypically identified as Acinetobacter calcoaceticus-A baumannii complex using the API ID 32GN system. The presence of A baumannii in the aspirate was also directly detected by multiplex PCR. RESULTS: Ten of the 114 endotracheal aspirate cultures were positive for A calcoaceticus-A baumannii complex, and only nine of the isolates were confirmed as A baumannii by the multiplex PCR. Direct PCR detection showed that 40 (35.1%) of the endotracheal aspirates were positive for A baumannii. Using positive culture of A baumannii as the gold standard, the sensitivity of direct PCR detection was 100% (6 of 6), the specificity was 70.4% (38 of 54), the positive predictive value was 27.3% (6 of 22), and the negative predictive value (NPV) was 100% (38 of 38) among patients with A baumannii pneumonia. Among patients with A baumannii colonization, the sensitivity of direct PCR detection was 100% (3 of 3), the specificity was 70.6% (36 of 51), the positive predictive value was 16.7% (3 of 18), and the NPV was 100% (36 of 36). CONCLUSION: Direct PCR detection of A baumannii in endotracheal aspirates has a high sensitivity and NPV as compared with culture-based methods. Further studies are needed to determine the clinical applicability of this rapid detection test.
BACKGROUND: We aim to evaluate the efficacy of polymerase chain reaction (PCR) to detect Acinetobacter baumannii in endotracheal aspirates. METHODS: Endotracheal aspirates and clinical data were collected from patients who were admitted to the intensive care unit of Taipei Veterans General Hospital between April 1 and August 31 in 2006. Bacterial isolates from endotracheal aspirate cultures were phenotypically identified as Acinetobacter calcoaceticus-A baumannii complex using the API ID 32GN system. The presence of A baumannii in the aspirate was also directly detected by multiplex PCR. RESULTS: Ten of the 114 endotracheal aspirate cultures were positive for A calcoaceticus-A baumannii complex, and only nine of the isolates were confirmed as A baumannii by the multiplex PCR. Direct PCR detection showed that 40 (35.1%) of the endotracheal aspirates were positive for A baumannii. Using positive culture of A baumannii as the gold standard, the sensitivity of direct PCR detection was 100% (6 of 6), the specificity was 70.4% (38 of 54), the positive predictive value was 27.3% (6 of 22), and the negative predictive value (NPV) was 100% (38 of 38) among patients with A baumannii pneumonia. Among patients with A baumannii colonization, the sensitivity of direct PCR detection was 100% (3 of 3), the specificity was 70.6% (36 of 51), the positive predictive value was 16.7% (3 of 18), and the NPV was 100% (36 of 36). CONCLUSION: Direct PCR detection of A baumannii in endotracheal aspirates has a high sensitivity and NPV as compared with culture-based methods. Further studies are needed to determine the clinical applicability of this rapid detection test.
Authors: K A Porter; J Rhodes; S Dejsirilert; S Henchaichon; D Siludjai; S Thamthitiwat; P Prapasiri; P Jorakate; A Kaewpan; L F Peruski; A Kerdsin; K Prasert; S Yuenprakone; S A Maloney; H C Baggett Journal: Epidemiol Infect Date: 2013-09-04 Impact factor: 2.451
Authors: Patrick Ketter; M Neal Guentzel; James P Chambers; James Jorgensen; Clinton K Murray; Andrew P Cap; Jieh-Juen Yu; Mark Eppinger; Bernard P Arulanandam Journal: Genome Announc Date: 2014-02-06