• Mrinal Sircar, Prashant Ranjan, Rajesh Gupta, Onkar Kumar Jha, Amit Gupta, Ravneet Kaur, Neela Chavhan, Mukta Singh, and Sujeet Kumar Singh.
• Department of Pulmonology and Critical Care Medicine, Fortis Hospital, Noida, Uttar Pradesh, India. Electronic address: mrinal.sircar@fortishealthcare.com.
• J Crit Care. 2016 Feb 1; 31 (1): 227-32.

PurposeThe purpose of the study is to evaluate the impact of adding bronchoalveolar lavage multiplex polymerase chain reaction (M-PCR) to conventional cultures (CC) on microbiological yield and therapeutic decisions in adult intensive care unit patients with pneumonia and severe sepsis or septic shock.Material And MethodsIn this retrospective case-control study, bronchoalveolar lavage cultures were taken for control (58 patients, 58 admissions) and study arms (57 patients, 58 admissions). Bronchoalveolar lavage M-PCR was sent simultaneously for the latter.ResultsA total of 267 microorganisms were identified (M-PCR alone, 211; CC alone, 15; both, 41) in the study arm vs 64 in controls. Concordance between M-PCR and culture was complete in 32 (55.17%), partial in 4 (6.9%), and discordant in 22 (37.93%) including 17 with positive M-PCR but negative CC. Time to antibiotic therapy modification was significantly less (P < .001) in M-PCR group compared to controls (32.40 ± 14.41 vs 41.74 ± 45.61 hours). There was no significant difference in index episode resolution (48.3% vs 50%; P = 1), intensive care unit mortality (57.4% vs 51.2%; P = .67), and hospital mortality (59.6% vs 61.5%; P = 1) in study and control arms, respectively, despite more septic shock patients in the study arm (89.7% vs 75.9%; P = .05).ConclusionBronchoalveolar lavage M-PCR with culture leads to higher microbiological yield and earlier modification of antibiotics compared to conventional culture.Copyright © 2015 Elsevier Inc. All rights reserved.

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