Syndromic Multiplex Polymerase Chain Reaction: The Impact on Microbial Yield in Nonventilator Hospital-Acquired
Jon Anders Feet1,2, Karl Erik Müller1,2, Øyvind Kommedal1,3
1Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, Faculty of Medicine, University of Bergen, Norway.
Open Forum Infectious Diseases
|May 25, 2026
Summary
Multiplex PCR (mPCR) significantly improves diagnosis of nonventilator hospital-acquired pneumonia (NV-HAP) by yielding faster results and higher pathogen detection rates compared to traditional bacterial cultures.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Clinical Microbiology
Background:
- Nonventilator hospital-acquired pneumonia (NV-HAP) is a significant cause of hospital infection with high morbidity and mortality.
- Conventional bacterial cultures for NV-HAP diagnosis have limitations in sensitivity and pathogen identification.
- This study addresses the need for improved diagnostic methods in NV-HAP management.
Purpose of the Study:
- To evaluate a rapid, culture-independent multiplex PCR (mPCR) assay for NV-HAP diagnosis.
- To compare mPCR with standard culture methods for microbial etiology detection.
- To assess the impact of mPCR on antimicrobial prescribing and NV-HAP incidence.
Main Methods:
- Prospective screening of NV-HAP patients in a Norwegian hospital (June 2021-November 2024).
- Analysis of lower respiratory tract samples using a syndromic multiplex PCR assay.
- Comparison of mPCR results with conventional bacterial culture methods.
Main Results:
- Bacterial pathogens were detected in 51.2% of mPCR samples versus 23.5% of culture samples (P < .01).
- Median time to results was 2.5 hours for mPCR vs. 45.8 hours for culture (P < .01).
- Antibiotic therapy was modified in 15.1% of patients based on mPCR results.
Conclusions:
- Syndromic multiplex PCR (mPCR) offers a faster and more sensitive diagnostic approach for NV-HAP.
- mPCR enhances the detection of microbial etiology compared to traditional culture methods.
- This molecular diagnostic approach has the potential to optimize NV-HAP patient management.
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