Multiplex PCR outperforms culture for rapid pathogen and resistance gene detection in surgical drainage fluids
Investigators prospectively evaluated a multiplex pathogen real-time PCR assay against conventional culture for detecting pathogens and antimicrobial resistance genes in postoperative intra-abdominal infection drainage fluids. The study reports that the molecular assay achieved higher positive detection rates than culture at both the patient (73.1% versus 57.7%) and specimen levels (76.2% versus 61.9%), while capturing a broader pathogen spectrum. Detection of key resistance markers, including AmpC and KPC, showed strong concordance with antimicrobial susceptibility testing, and targeted next-generation sequencing confirmed the reliability of the PCR results. These findings position multiplex PCR as a complementary diagnostic tool that could accelerate pathogen identification and inform targeted antimicrobial therapy in surgical settings.
The original study
Clinical evaluation of multiplex pathogen real-time PCR for early detection of pathogens and antimicrobial resistance genes in intra-abdominal infections.
- Authors
- Niu JF, Ma R, Yu WJ, Zhang YM, Song ZY, Guo XY, et al.
- Journal
- World journal of microbiology & biotechnology
- Type
- Journal Article, Evaluation Study
- PMID
- 42728533
Original abstract
Rapid pathogen identification is essential for the management of post-operative intra-abdominal infections. However, conventional culture is often time-consuming and has limited pathogen coverage. Our study aimed to evaluate the performance of multiplex pathogen real-time polymerase chain reaction (MP-PCR) in detecting pathogens and antimicrobial resistance genes (ARGs) from postoperative drainage fluids. A total of 63 drainage fluid specimens were prospectively collected from 52 patients who underwent abdominal surgery and were included in the final analysis. All specimens were detected in parallel using conventional culture and MP-PCR, and a set of specimens were further validated via targeted next-generation sequencing(tNGS). MP-PCR yielded significantly higher positive detection rates than conventional culture at both the patient level (73.1% vs. 57.7%) and specimen level (76.2% vs. 61.9%). Pathogen spectrum analysis revealed that bacteria constituted the predominant pathogens identified by both methods, whereas MP-PCR exhibited a broader pathogen spectrum. MP-PCR showed higher frequencies for major clinically relevant bacteria associated with intra-abdominal infections and demonstrated substantial consistency with conventional culture results. Additionally, the identification of ARGs (mainly AmpC and KPC) shown excellent consistence with antimicrobial susceptibility test (AST). Furthermore, tNGS further validated the reliability of MP-PCR-based pathogen identification. In conclusion, these findings suggested that MP-PCR serves as a robust and complementary molecular tool for the early detection of pathogens and ARGs in postoperative drainage fluids, holding great potential to optimize the diagnosis and targeted treatment of postoperative intra-abdominal infections.