title: A Pilot Study of Quantitative Loop-mediated Isothermal Amplification-guided Target Therapies for Hospital-acquired Pneumonia.
abstract: BACKGROUND
  It is important to achieve the definitive pathogen identification in hospital-acquired pneumonia (HAP), but the traditional culture results always delay the target antibiotic therapy. We assessed the method called quantitative loop-mediated isothermal amplification (qLAMP) as a new implement for steering of the antibiotic decision-making in HAP.
  
  
  METHODS
  Totally, 76 respiratory tract aspiration samples were prospectively collected from 60 HAP patients. DNA was isolated from these samples. Specific DNA fragments for identifying 11 pneumonia-related bacteria were amplified by qLAMP assay. Culture results of these patients were compared with the qLAMP results. Clinical data and treatment strategies were analyzed to evaluate the effects of qLAMP results on clinical data. McNemar test and Fisher's exact test were used for statistical analysis.
  
  
  RESULTS
  The detection of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Stenotrophomonas maltophilia, Streptococcus pneumonia, and Acinetobacter baumannii by qLAMP was consistent with sputum culture (P > 0.05). The qLAMP results of 4 samples for Haemophilus influenzae, Legionella pneumophila, or Mycoplasma pneumonia (MP) were inconsistent with culture results; however, clinical data revealed that the qLAMP results were all reliable except 1 MP positive sample due to the lack of specific species identified in the final diagnosis. The improvement of clinical condition was more significant (P < 0.001) in patients with pathogen target-driven therapy based on qLAMP results than those with empirical therapy.
  
  
  CONCLUSIONS
  qLAMP is a more promising method for detection of pathogens in an early, rapid, sensitive, and specific manner than culture.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.forename: Ran
authors.initials: R
authors.lastname: Li
authors.forename: Ying
authors.initials: Y
authors.lastname: Shang
authors.forename: Can
authors.initials: C
authors.lastname: Wang
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Wang
authors.forename: De-Xun
authors.initials: DX
authors.lastname: Zhou
authors.forename: Dong-Hong
authors.initials: DH
authors.lastname: Yang
authors.forename: Wen
authors.initials: W
authors.lastname: Xi
authors.forename: Ke-Qiang
authors.initials: KQ
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Bao
authors.forename: Yu
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Zhan-Cheng
authors.initials: ZC
authors.lastname: Gao
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D010865:Pilot Projects; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000472:pathogenicity
chemical_list: D000900:Anti-Bacterial Agents
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