Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ)

Members of the CAPNETZ study group

doi:10.1007/s15010-021-01720-8

Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ)

Members of the CAPNETZ study group

Abstract

Purpose: Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Methods: Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. Results: In total of 200 patients Staphylococcus aureus (27.0%), Haemophilus influenzae (13.5%), Streptococcus pneumoniae (5.5%), Moraxella catarrhalis (2.5%), and Legionella pneumophila (1.5%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. Conclusion: General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients.

Original language	English
Journal	Infection
Volume	49
Issue number	6
Pages (from-to)	1299-1306
Number of pages	8
ISSN	0300-8126
DOIs	https://doi.org/10.1007/s15010-021-01720-8
Publication status	Published - 12.2021

Funding

Members of the CAPNETZ study group: M. Dreher, C. Cornelissen, W. Knüppel, D. Stolz, N. Suttorp, P. Creutz, A. Mikolajewska, A. le Claire, M. Benzke, T. Bauer, D. Krieger, M. Prediger, S. Schmager, M. Kolditz, B. Schulte-Hubbert, S. Langner, O. Degen, A. Hüfner, C. Hoffmann, T. Welte, J. Freise, G. Barten-Neiner, M. Nawrocki, I. Fuge, J. Naim, W. Kröner, T. Illig, N. Klopp, C. Kroegel, A. Moeser, B. Schleenvoigt, C. Forstner, D. Drömann, P. Parschke, K. Franzen, J. Rupp, N. Käding, E. Wouters, K. Walraven, D. Braeken, C. Spinner, H. Buschmann, A. Zaruchas, T. Schaberg, I. Hering, W. Albrich, F. Waldeck, F. Rassouli, S. Baldesberger, M. Panning, M. Wallner. The investigators of this scientific work acknowledge CAPNETZ STIFTUNG and the competence network CAPNETZ for project support with regard to using biomaterials and clinical data. CAPNETZ is a multidisciplinary approach to better understand and treat patients with CAP. The network has been made possible by the contributions of many investigators. Financial support. CAPNETZ is supported by the German Center for Lung Research (DZL) FKZ: 82DZL002A4. Members of the CAPNETZ study group: M. Dreher, C. Cornelissen, W. Kn?ppel, D. Stolz, N. Suttorp, P. Creutz, A. Mikolajewska, A. le Claire, M. Benzke, T. Bauer, D. Krieger, M. Prediger, S. Schmager, M. Kolditz, B. Schulte-Hubbert, S. Langner, O. Degen, A. H?fner, C. Hoffmann, T. Welte, J. Freise, G. Barten-Neiner, M. Nawrocki, I. Fuge, J. Naim, W. Kr?ner, T. Illig, N. Klopp, C. Kroegel, A. Moeser, B. Schleenvoigt, C. Forstner, D. Dr?mann, P. Parschke, K. Franzen, J. Rupp, N. K?ding, E. Wouters, K. Walraven, D. Braeken, C. Spinner, H. Buschmann, A. Zaruchas, T. Schaberg, I. Hering, W. Albrich, F. Waldeck, F. Rassouli, S. Baldesberger, M. Panning, M. Wallner. The investigators of this scientific work acknowledge CAPNETZ STIFTUNG and the competence network CAPNETZ for project support with regard to using biomaterials and clinical data. CAPNETZ is a multidisciplinary approach to better understand and treat patients with CAP. The network has been made possible by the contributions of many investigators. Financial support. CAPNETZ is supported by the German Center for Lung Research (DZL) FKZ: 82DZL002A4. Open Access funding enabled and organized by Projekt DEAL. Christoph Spinner reports grants, personal fees, and non-financial support from AbbVie; grants, personal fees, and non-financial support from Apeiron; grants, personal fees from Braun; grants from Cepheid; personal fees from Formycon; grants, personal fees, and non-financial support from Gilead Sciences; grants and personal fees from Eli Lilly; grants, personal fees, and non-financial support from Janssen-Cilag; grants, personal fees, and non-financial support from GSK/ViiV Healthcare; grants, personal fees, and non-financial support from MSD, outside the submitted work. Mathias W. Pletz reports grants from Pfizer and personal fees from MSD, Thermofisher, Ciesi, Novartis, GSK and Bayer. Jochen Schneider reports grants, personal fees, and non-financial support from AbbVie, Gilead, Janssen and Dr. Falk GmbH.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

Research Areas and Centers

Academic Focus: Center for Infection and Inflammation Research (ZIEL)

DFG Research Classification Scheme

2.21-03 Medical Microbiology and Mycology, Hygiene, Molecular Infection Biology
2.22-13 Pneumology, Thoracic Surgery

Coronavirus related work

Research on SARS-CoV-2 / COVID-19

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10.1007/s15010-021-01720-8

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@article{56023606b25e4542a95a9e15b50d89a5,

title = "Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ)",

abstract = "Purpose: Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Methods: Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. Results: In total of 200 patients Staphylococcus aureus (27.0\%), Haemophilus influenzae (13.5\%), Streptococcus pneumoniae (5.5\%), Moraxella catarrhalis (2.5\%), and Legionella pneumophila (1.5\%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. Conclusion: General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients.",

author = "\{Members of the CAPNETZ study group\} and Kathrin Rothe and C. Spinner and Marcus Panning and Pletz, \{Mathias W.\} and Gernot Rohde and J. Rupp and Martin Witzenrath and Johanna Erber and Frank Eberhardt and Andreas Essig and Jochen Schneider and M. Dreher and C. Cornelissen and W. Kn{\"u}ppel and D. Stolz and N. Suttorp and P. Creutz and A. Mikolajewska and \{le Claire\}, A. and M. Benzke and T. Bauer and D. Krieger and M. Prediger and S. Schmager and M. Kolditz and B. Schulte-Hubbert and S. Langner and O. Degen and A. H{\"u}fner and C. Hoffmann and T. Welte and J. Freise and G. Barten-Neiner and M. Nawrocki and I. Fuge and J. Naim and W. Kr{\"o}ner and T. Illig and N. Klopp and C. Kroegel and A. Moeser and B. Schleenvoigt and C. Forstner and D. Dr{\"o}mann and P. Parschke and K. Franzen and J. Rupp and N. K{\"a}ding and E. Wouters and F. Waldeck",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1007/s15010-021-01720-8",

language = "English",

volume = "49",

pages = "1299--1306",

journal = "Infection",

issn = "0300-8126",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "6",

}

Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ). / Members of the CAPNETZ study group.
In: Infection, Vol. 49, No. 6, 12.2021, p. 1299-1306.

Research output: Journal Articles › Journal articles › Research › peer-review

TY - JOUR

T1 - Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19

T2 - A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ)

AU - Members of the CAPNETZ study group

AU - Rothe, Kathrin

AU - Spinner, C.

AU - Panning, Marcus

AU - Pletz, Mathias W.

AU - Rohde, Gernot

AU - Rupp, J.

AU - Witzenrath, Martin

AU - Erber, Johanna

AU - Eberhardt, Frank

AU - Essig, Andreas

AU - Schneider, Jochen

AU - Dreher, M.

AU - Cornelissen, C.

AU - Knüppel, W.

AU - Stolz, D.

AU - Suttorp, N.

AU - Creutz, P.

AU - Mikolajewska, A.

AU - le Claire, A.

AU - Benzke, M.

AU - Bauer, T.

AU - Krieger, D.

AU - Prediger, M.

AU - Schmager, S.

AU - Kolditz, M.

AU - Schulte-Hubbert, B.

AU - Langner, S.

AU - Degen, O.

AU - Hüfner, A.

AU - Hoffmann, C.

AU - Welte, T.

AU - Freise, J.

AU - Barten-Neiner, G.

AU - Nawrocki, M.

AU - Fuge, I.

AU - Naim, J.

AU - Kröner, W.

AU - Illig, T.

AU - Klopp, N.

AU - Kroegel, C.

AU - Moeser, A.

AU - Schleenvoigt, B.

AU - Forstner, C.

AU - Drömann, D.

AU - Parschke, P.

AU - Franzen, K.

AU - Rupp, J.

AU - Käding, N.

AU - Wouters, E.

AU - Waldeck, F.

PY - 2021/12

Y1 - 2021/12

N2 - Purpose: Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Methods: Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. Results: In total of 200 patients Staphylococcus aureus (27.0%), Haemophilus influenzae (13.5%), Streptococcus pneumoniae (5.5%), Moraxella catarrhalis (2.5%), and Legionella pneumophila (1.5%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. Conclusion: General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients.

AB - Purpose: Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Methods: Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. Results: In total of 200 patients Staphylococcus aureus (27.0%), Haemophilus influenzae (13.5%), Streptococcus pneumoniae (5.5%), Moraxella catarrhalis (2.5%), and Legionella pneumophila (1.5%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. Conclusion: General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients.

UR - https://www.scopus.com/pages/publications/85118160139

U2 - 10.1007/s15010-021-01720-8

DO - 10.1007/s15010-021-01720-8

M3 - Journal articles

C2 - 34687426

AN - SCOPUS:85118160139

SN - 0300-8126

VL - 49

SP - 1299

EP - 1306

JO - Infection

JF - Infection

IS - 6

ER -

Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: A multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ)

Abstract

Funding

UN SDGs

Research Areas and Centers

DFG Research Classification Scheme

Coronavirus related work

Access to Document

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