Multiplex PCR syndromic testing in intensive care units

Abstract

The recent development of multiplex PCR syndromic assays, able to detect dozens of pathogens within a few hours, has led to a paradigm shift in microbiology and clinical practice. Several of them, such as the panels detecting pathogens responsible for bacteremia, high or low respiratory infections or meningoencephalitis, are already available and can be used to help in the diagnosis of infections among intensive care units patients. Although these new techniques have obvious advantages such as the high number of microorganisms simultaneously tested, detection of resistance genes, and very short delay of results, they also present strong challenges, such as their exact performance assessment, their high cost, the best strategies of use and sometimes complex interpretation of the results. In this article, we review the different panels of syndromic assays currently available that can or will help ICU physicians in their daily practice. We will highlight both their limitations and their potential beneficial impacts on patient care.