Comprehensive Molecular Testing for Respiratory Pathogens in Community-Acquired Pneumonia

Gadsby, Naomi J.; Russell, Clark D.; McHugh, Martin P.; Mark, Harriet; Conway Morris, Andrew; Laurenson, Ian F.; Hill, Adam T.; Templeton, Kate E.

Neither culture-positivity nor PCR-positivity was associated with the outcome of infection (P = .2; odds ratio [OR] = 1.5; 95% confidence interval [CI], .8-2.9; and P = .8; OR = .9; 95% CI, .4-2.6, respectively). Polymicrobial detection was also not associated with the outcome of infection (P = .4; OR = 1.3; 95% CI, .7-2.5). The bacterial load of S. pneumoniae was associated with the outcome of infection on univariate analysis, with a higher load present in patients with 30-day mortality and/or ICU admission (4.33 × 10 8 CFU/mL vs 1.29 × 10 8 CFU/mL; P = .009). However, the CURB-65 score (CURB-65; Confusion of new onset, blood Urea nitrogen >7 mmol/l , Respiratory rate ≥30 breaths per minute, Blood pressure <90 mmHg systolic or ≤60 mmHg diastolic, age ≥65 years) was also associated with outcome on univariate analysis (P = .01). When logistic regression was used to correct for CURB-65 score in patients with S. pneumoniae infection, bacterial load was no longer significantly associated with outcome (P = .09; Supplementary Table 4 ).