Beyond Culture: Real-Time PCR Performance in Detecting Causative Pathogens and Key Antibiotic Resistance Genes in...

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Rising incidence of hospital-acquired pneumonia (HAP) driven by antibiotic-resistant bacteria.
• Increased morbidity, mortality, and suboptimal empirical antibiotic use in HAP cases.
• Need for rapid and accurate diagnostic methods for HAP pathogens and resistance mechanisms.

Purpose of the Study:

• Evaluate the performance of real-time polymerase chain reaction (PCR) for HAP diagnosis.
• Compare real-time PCR to traditional methods for detecting causative microorganisms and resistance genes.
• Determine the molecular epidemiology of antibiotic resistance genes in HAP patients at The University of Jordan hospital.

Main Methods:

• Prospective collection of lower respiratory tract samples from HAP and ventilator-associated pneumonia (VAP) patients.
• Clinical data analysis including demographics, clinical information, and outcomes.
• Real-time PCR assay for simultaneous detection of pathogens and antibiotic resistance genes.

Main Results:

• Real-time PCR demonstrated higher detection rates for key pathogens like *Acinetobacter baumannii* and *Klebsiella pneumoniae* compared to culture.
• High prevalence of carbapenem resistance was observed, with frequent detection of *bla*NDM and *bla*OXA-48 genes.
• Detected resistance genes in all carbapenem-resistant cases, showing significant association with phenotypic resistance.

Conclusions:

• Real-time PCR is a rapid and effective tool for improving HAP diagnosis and management by identifying pathogens and resistance genes.
• Molecular epidemiology of antibiotic resistance genes provides crucial data for understanding resistance patterns in HAP.
• Further large-scale, multicenter studies are warranted to validate real-time PCR performance in HAP diagnosis.