Cumulative respiratory pathogen detection burden by multiplex PCR is associated with mortality in a TB-enriched ICU cohort.
Higher pathogen count was associated with increased in-hospital mortality.
Cumulative respiratory pathogen detection burden by multiplex PCR is associated with mortality in a TB-enriched ICU cohort.
UNLABELLED: Rapid multiplex polymerase chain reaction (mPCR) is increasingly used in intensive care units (intensive care units), but the prognostic value of cumulative pathogen detection burden in critically ill patients with suspected pulmonary tuberculosis (tuberculosis) or complex respiratory infections remains unclear.
We retrospectively studied 130 intensive care units patients with severe respiratory symptoms and suspected tuberculosis or complex respiratory infections.
each additional pathogen detected meant a higher chance of dying in the hospital
The mPCR positivity rate was 93.8%, with mixed-category co-detections in 46.9%.
The most frequently detected targets were Mycobacterium tuberculosis (65.4%), Candida albicans (38.5%), and Pseudomonas aeruginosa (30.0%).
Receiver operating characteristic analysis identified an exploratory threshold of >3 detected targets for mortality risk stratification.
Sensitivity analyses excluding Candida albicans or detections with raw Ct values >35 showed similar findings.
Prospective multicenter studies incorporating adjudicated infection status, antimicrobial exposure, host immune status, and semi-quantitative pathogen-load metrics are needed to validate whether this metric can be incorporated into intensive care units prognostic models.