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Patterns and predictors of positive multiplex polymerase chain reaction respiratory panel among patients with acute respiratory infections in a single center in Lebanon

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Abstract

Background

Infectious agents associated with community-acquired acute respiratory infections (ARIs) remain understudied in Lebanon. We aim to assess the microbiological profiles of ARIs by employing polymerase chain reaction (PCR) and identifying predictors of positive PCR results among patients admitted for ARI.

Methods and results

We conducted a retrospective single-center study at the American University of Beirut Medical Center, including all respiratory PCR panels performed on pediatric (< 18) and adult (≥ 18) patients presenting with an ARI from January 2015 to March 2018, prior to the onset of the COVID-19 pandemic. We aimed to identify the epidemiological patterns of ARIs and the factors associated with positive PCRs in both adult and pediatric patients. Among 281 respiratory PCRs, 168 (59.7%) were positive for at least one pathogen, with 54.1% positive PCR for viruses, 7.8% for bacteria species, and 3.9% with virus-bacteria codetection. Almost 60% of the patients received antibiotics prior to PCR testing. PCR panels yielded more positive results in pediatric patients than in adults (P = 0.005). Bacterial detection was more common in adults compared to pediatrics (P < 0.001). The most common organism recovered in the entire population was Human Rhinovirus (RhV) (18.5%). Patients with pleural effusion on chest CT were less likely to have a positive PCR (95% Cl: 0.22–0.99). On multivariate analysis, pediatric age group (P < 0.001), stem cell transplant (P = 0.006), fever (P = 0.03) and UTRI symptoms (P = 0.004) were all predictive of a positive viral PCR.

Conclusion

Understanding the local epidemiology of ARI is crucial for proper antimicrobial stewardship. The identification of factors associated with positive respiratory PCR enhances our understanding of clinical characteristics and potential predictors of viral detection in our population.

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Data availability

The data presented in this study is available on request from the corresponding author. The data is not publicly available due to patient privacy.

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Funding

This research received no external funding.

Author information

Author notes

  1. Aline El Zakhem and Omar Mahmoud are contributed equally.

Authors and Affiliations

  1. Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, 110236, Lebanon

    Aline El Zakhem & Omar Mahmoud

  2. Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon

    Hisham Bou Fakhreddine & Imad Bouakl

  3. Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Rami Mahfouz

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  1. Aline El Zakhem
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Contributions

Conceptualization: AEZ, IBA, Formal Analysis: HBF Writing – review and editing: OM, AEZ, RM, IBA Writing –original draft: OM, AEZ, RM Methodology: AEZ, IBA, HBF. All authors have read and approved the final version of the manuscript and IBA as corresponding author had full access to all of the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Imad Bouakl.

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Ethical approval

The study was approved by the Institutional Review Board at AUBMC and the IRB ID is BIO-2018-0102. Patient consent was waived as this was a retrospective chart review. The ethical issues encountered in this study were minimal as this was a retrospective study and anonymization of patients was maintained for the purposes of data analysis.

Competing interests

The authors declare no competing interests.

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El Zakhem, A., Mahmoud, O., Bou Fakhreddine, H. et al. Patterns and predictors of positive multiplex polymerase chain reaction respiratory panel among patients with acute respiratory infections in a single center in Lebanon. Mol Biol Rep 51, 346 (2024). https://doi.org/10.1007/s11033-023-09133-6

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