The purpose of the study was to evaluate the clinical utility of multiplex PCR for detecting bacterial respiratory pathogens in nasopharyngeal samples. Acutely ill adults in the emergency department with respiratory infection symptoms, fever, chest pain or poor general condition were enrolled for this cohort study. Samples were stored at –70 °C until being analysed with multiplex PCR for seven respiratory bacteria. Of the 912 patients enrolled, those with positive bacterial samples (n = 130, 14%) were significantly younger than those with a negative finding (55.5 years vs 62.2 years, p < 0.001), and their mean C‐reactive protein (CRP) concentration was higher (110 mg/L vs 59 mg/L, p < 0.0001). Patients with a positive respiratory bacterial finding had a higher probability of pneumonia (35% vs 13%, p < 0.001) and a higher likelihood of receiving a prescription for antibiotics than those with a negative finding (79% vs 59%, p < 0.0001). Positive detection of Streptococcus pneumoniae was associated with a 4.5‐fold risk of pneumonia in a multivariate model and detection of an atypical respiratory pathogen with a 9‐fold risk. Bacterial PCR performed on nasopharyngeal samples appeared to offer a valuable addition to the diagnostics of infections in adults in acute care.

中文翻译：

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急性护理中呼吸道细菌的多重 PCR

本研究的目的是评估多重 PCR 检测鼻咽样本中细菌性呼吸道病原体的临床效用。本队列研究招募了急诊科有呼吸道感染症状、发烧、胸痛或一般状况不佳的急症成人。样品储存在 –70 °C 下，直到使用多重 PCR 分析七种呼吸道细菌。在纳入的 912 名患者中，细菌样本呈阳性的患者 (n = 130, 14%) 明显比阴性结果的患者年轻 (55.5 岁 vs 62.2 岁，p < 0.001)，而且他们的平均 C 反应蛋白 (CRP)浓度较高（110 mg/L vs 59 mg/L，p < 0.0001）。与阴性结果的患者相比，呼吸道细菌阳性的患者患肺炎的可能性更高（35% vs 13%，p < 0.001），并且接受抗生素处方的可能性也更高（79% vs 59%，p < 0.0001） ）。阳性检测肺炎链球菌在多变量模型中，与肺炎的 4.5 倍风险相关，而检测到非典型呼吸道病原体的风险则为 9 倍。对鼻咽样本进行的细菌 PCR 似乎为急性护理成人感染的诊断提供了有价值的补充。