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Updated: Oct 16, 2026
Rapid Point-of-Care Detection of Pathogens for Lower Respiratory Tract Infections in ICU Patients
Published on: September 19, 2026
Use of RAPD-ALF analysis for investigating the frequency of bacterial cross-transmission in an adult intensive care
1Department of Microbiology & PHLS Laboratory, University Hospital, Queen's Medical Centre, Nottingham, NG7 2UH.
Abstract:
Bacterial cross-transmission was investigated during a 12-month period in an adult intensive care unit (ICU) by the generation of random amplified polymorphic DNA (RAPD) fingerprinting profiles, combined with automated laser fluorescence (ALF) analysis. The potential episodes of cross-transmission identified, were compared with those detected by the conventional first-line screen of antibiogram typing. Over the year, 215 primary gram-negative bacterial isolates were obtained from 160 patients. In total, 22 possible episodes of cross-transmission, involving 70 (44%) of the 160 patients, were identified by RAPD-ALF analysis, and 19 of these were substantiated with epidemiological evidence. Conversely, 31 possible episodes were identified on the basis of antibiogram data, but only three of these episodes, two involving Acinetobacter baumannii and one involving Serratia marcescens, correlated with those identified by RAPD-ALF analysis. It was concluded that analysis of antibiogram data alone is an unreliable method for assessing bacterial cross-transmission, unless the organism involved has a particularly stable or unusual resistance pattern. In contrast, the technique of RAPD-ALF analysis may provide a rapid and simple technique for obtaining an insight into the population dynamics of gram-negative bacteria in adult ICUs.
Insights
Random amplified polymorphic DNA (RAPD)-automated laser fluorescence (ALF) analysis effectively identified bacterial cross-transmission in an adult intensive care unit (ICU). Antibiogram typing alone is unreliable for detecting patient-to-patient bacterial spread.
Area of Science:
- Microbiology
- Infectious Diseases
- Intensive Care Medicine
Background:
- Bacterial cross-transmission poses a significant risk in intensive care units (ICUs).
- Accurate detection methods are crucial for infection control.
- Conventional antibiogram typing has limitations in identifying transmission events.
Purpose of the Study:
- To compare the efficacy of random amplified polymorphic DNA (RAPD)-automated laser fluorescence (ALF) analysis with conventional antibiogram typing for detecting bacterial cross-transmission in an adult ICU.
- To assess the reliability of antibiogram data for identifying gram-negative bacterial spread.
Main Methods:
- A 12-month prospective study in an adult ICU.
- Generation of random amplified polymorphic DNA (RAPD) fingerprinting profiles.
- Automated laser fluorescence (ALF) analysis for bacterial strain differentiation.
- Comparison of RAPD-ALF results with conventional antibiogram typing.
Main Results:
- 215 gram-negative bacterial isolates from 160 patients were analyzed.
- RAPD-ALF identified 22 possible cross-transmission episodes, involving 70 patients, with 19 confirmed by epidemiology.
- Antibiogram typing identified 31 possible episodes, but only 3 correlated with RAPD-ALF findings.
Conclusions:
- Random amplified polymorphic DNA (RAPD)-automated laser fluorescence (ALF) analysis is a reliable and rapid method for investigating gram-negative bacterial cross-transmission in ICUs.
- Conventional antibiogram typing is unreliable for assessing bacterial spread unless organisms have unique resistance patterns.
- RAPD-ALF provides valuable insights into bacterial population dynamics in critical care settings.
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