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.

Clearly, a large number of additional factors influence antimicrobial selection (eg, severity of illness, concurrent infection at sites other than the lower respiratory tract, drug allergy, antimicrobial susceptibility testing, inflammatory markers), and we do not suggest that sputum PCR testing alone will be sufficient. However, the lack of positive microbiological identification is a significant issue, and it is highly likely that enhancing the detection of pathogens and reporting of bacterial loads would have a major impact on the clinical decision-making process. Therefore, our study illustrates the feasibility of providing the physician with significantly more information on which to base treatment decisions than is currently available and suggests that comprehensive PCR testing including bacterial load quantitation should be one of the inputs to future prospective studies in this area.