Syndromic Multiplex Polymerase Chain Reaction: The Impact on Microbial Yield in Nonventilator Hospital-Acquired Pneumonia.

Background: Nonventilator hospital-acquired pneumonia (NV-HAP) is a leading cause of hospital-acquired infection, associated with substantial morbidity and mortality. Conventional bacterial cultures from lower respiratory tract specimens, as recommended by current guidelines, have limited sensitivity and frequently fail to identify causative pathogens. This study evaluated a rapid, culture-independent molecular diagnostic approach versus standard methods for identifying microbial etiology, assessing antimicrobial prescribing, and determining NV-HAP incidence in a medium-sized Norwegian hospital. We hypothesized that multiplex polymerase chain reaction (mPCR) would shorten time to diagnosis and increase microbial yield. Method: A screening process twice daily was established to prospectively identify NV-HAP patients eligible for inclusion in a single hospital from 11 June 2021 to 26 November 2024. Lower respiratory tract samples were analyzed using a syndromic multiplex PCR assay and compared with conventional culture methods. Results: Eighty-six patients were included, with bacterial pathogens detected in 51.2% of the samples analyzed by mPCR and in 23.5% of cultured samples ( Conclusions: The use of syndromic mPCR provided faster results and a higher detection rate for microbial etiology compared to traditional culture methods.