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Respiratory multiplex PCR and antimicrobial treatment modification in hospitalized patients with community-acquired

Hülya Çaşkurlu1, Halenur Vural Akbal1, Hatice Kübra Uçar1

  • 1Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye.

Antimicrobial Stewardship & Healthcare Epidemiology : ASHE
|July 31, 2026
PubMed
Abstract

Insights

Multiplex PCR (mPCR) testing in community-acquired pneumonia (CAP) patients led to targeted antimicrobial treatment modifications, with most cases involving de-escalation. This highlights mPCR

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Pulmonology

Background:

  • Community-acquired pneumonia (CAP) is a significant cause of hospitalization.
  • Conventional microbiological methods for pathogen identification in CAP have a low diagnostic yield.
  • The role of respiratory multiplex PCR (mPCR) in guiding antimicrobial treatment for hospitalized CAP patients is not well-defined.

Purpose of the Study:

  • To evaluate the association between respiratory multiplex PCR (mPCR) testing and antimicrobial treatment modification in hospitalized patients with CAP.
  • To assess the impact of mPCR on antimicrobial de-escalation and hospital length of stay.

Main Methods:

  • Retrospective, single-center cohort study of hospitalized CAP patients (July 2023 - February 2025).
  • Respiratory mPCR performed within 24 hours of admission using nasopharyngeal/oropharyngeal swabs.
  • Primary outcome: antimicrobial treatment modification documented by physicians, guided by mPCR results.

Main Results:

  • A pathogen was detected by mPCR in 38.6% of 145 patients (30 viral, 26 bacterial).
  • Antimicrobial treatment was modified in 37.2% of patients; 25.5% of modifications were physician-documented and mPCR-guided.
  • Of mPCR-guided modifications, 94.6% resulted in antimicrobial de-escalation.
  • Hospital length of stay showed no significant difference based on mPCR results.

Conclusions:

  • Respiratory mPCR testing in hospitalized CAP patients facilitates targeted antimicrobial treatment modification.
  • mPCR use is associated with high rates of antimicrobial de-escalation, enhancing antimicrobial stewardship.
  • mPCR demonstrates significant utility in optimizing clinical decisions for CAP management.

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