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New research · Pulmonology & Critical Care
Microbiology spectrum · 1d
Cohort studyMicrobiology spectrum · 2026

Cumulative respiratory pathogen detection burden by multiplex PCR is associated with mortality in a TB-enriched ICU cohort.

Jurong Yan, Qian He, Lihui Zhao … Yi Ren
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Pulmonology & Critical CareCohort study

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.

Jurong Yan et al. · Microbiology spectrum · 2026
Background

UNLABELLED: Rapid multiplex polymerase chain reaction (mPCR) is increasingly used in intensive care units (ICUs), but the prognostic value of cumulative pathogen detection burden in critically ill patients with suspected pulmonary tuberculosis (TB) or complex respiratory infections remains unclear.

Methods

We retrospectively studied 130 ICU patients with severe respiratory symptoms and suspected TB or complex respiratory infections.

n = 130 ICU patients
Results

each additional pathogen detected meant a higher chance of dying in the hospital

OR 1.55 (95% CI 1.14 to 2.16)
null = 11.142.16
CI excludes the null - significant
More results

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%).

More results

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.

“
Conclusion

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 ICU prognostic models.

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