Simultaneous Detection of Key Bacterial Pathogens Related to Pneumonia and Meningitis Using Multiplex PCR Coupled With Mass Spectrometry

Zhang, Chi; Xiu, Leshan; Xiao, Yan; Xie, Zhengde; Ren, Lili; Peng, Junping

Mixed infections have been reported by different groups, with the rate of bacterial coinfection varying from 13% to approximately 33%; the most common combination is S. pneumoniae and H. influenzae (de Roux et al., 2006; Cilloniz et al., 2011b; Musher et al., 2017) . Bacterial coinfection is associated with severe disease and high mortality rates, so timely discovery of mixed etiologies is critical for antimicrobial treatment and clinical outcomes (Cilloniz et al., 2011a,b; Kumagai et al., 2015) . In our study, S. pneumoniae and H. influenzae were the most frequently identified coinfection bacteria, but multiple infections were found in 45.6% (93/204) of samples, which is higher than the percentage determined in other studies. In particular, we noticed that, when using realtime PCR alone, the concordance rate of results for samples with multiple infections was lower than that for single-infection samples. This finding suggests that the BP-MS method performs well in clarifying complicated polymicrobial etiologies.