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Am J Translational Res 2012;4(1):72-82
Original Article
Non-invasive detection of pulmonary pathogens in ventilator-circuit
filters by PCR
Richard J. Isaacs, Ken Debelak, Patrick R. Norris, Judith M. Jenkins, Jeffrey C. Rooks, Todd R. Young, Addison K.
May, Erik M. Boczko
Department of Biomedical Informatics Vanderbilt University Nashville, TN, USA; Department of Chemical
Engineering Vanderbilt University Nashville, TN, USA; 4Division of Trauma and Surgical Critical Care Vanderbilt
University Nashville, TN 37232, USA; 5Department of Respiratory Care Vanderbilt University Nashville, TN 37232,
USA; 6Depatment of Mathematics Ohio University Athens, OH, USA
Received November 13, 2011; accepted December 7, 2011; Epub January 5, 2012; Published January 15, 2012
Abstract: Ventilator associated pneumonia is a common and costly complication in critically ill and injured
surgical patients. The diagnosis of pneumonia remains problematic and non-specific. Using clinical criteria, a
diagnosis of pneumonia is typically not made until an infection is well established. Semi-quantitative cultures of
endotracheal aspirate and broncho-alveolar lavage are employed to improve the accuracy of diagnosis but are
invasive and require time for culture results to become available. We report data that show that an inexpensive,
rapid and non-invasive alternative may exist. In particular we show that: 1). Bio-aerosols evolved in the breath of
ventilated patients and captured in the hygroscopic condenser humidifier filter of the ventilator circuit contain
pathogenic micro-organisms. 2). The number (CFU/ml) and identity (Genus, species) of the pathogens in the
aerosol samples can rapidly and inexpensively be determined by PCR. 3). Data from a convenience sample of
filters correlate with clinical findings from standard microbiological methods such as broncho-alveolar lavage.
The evaluation of the bacterial load evolved in exhaled breath by PCR is amenable to repeated sampling. Since
increasing bacterial burden is believed to correlate with the establishment of infection, the use of quantitative
PCR may provide a method to rapidly, inexpensively, and effectively detect and diagnose the early onset of
pneumonia and identify pathogens involved. (AJTR1111002).
Keywords: Pneumonia, VAP, BAL, HME, HCH, infection
Full Text PDF
Address all correspondence to:
Dr. Erik M. Boczko
Department of Biomedical Informatics
Vanderbilt University
Nashville, TN 37233, USA.
Phone: (615) 936-6668, Fax:(615) 936-1427
E-mail: erik.boczko@vanderbilt.edu
Original Article
Non-invasive detection of pulmonary pathogens in ventilator-circuit
filters by PCR
Richard J. Isaacs, Ken Debelak, Patrick R. Norris, Judith M. Jenkins, Jeffrey C. Rooks, Todd R. Young, Addison K.
May, Erik M. Boczko
Department of Biomedical Informatics Vanderbilt University Nashville, TN, USA; Department of Chemical
Engineering Vanderbilt University Nashville, TN, USA; 4Division of Trauma and Surgical Critical Care Vanderbilt
University Nashville, TN 37232, USA; 5Department of Respiratory Care Vanderbilt University Nashville, TN 37232,
USA; 6Depatment of Mathematics Ohio University Athens, OH, USA
Received November 13, 2011; accepted December 7, 2011; Epub January 5, 2012; Published January 15, 2012
Abstract: Ventilator associated pneumonia is a common and costly complication in critically ill and injured
surgical patients. The diagnosis of pneumonia remains problematic and non-specific. Using clinical criteria, a
diagnosis of pneumonia is typically not made until an infection is well established. Semi-quantitative cultures of
endotracheal aspirate and broncho-alveolar lavage are employed to improve the accuracy of diagnosis but are
invasive and require time for culture results to become available. We report data that show that an inexpensive,
rapid and non-invasive alternative may exist. In particular we show that: 1). Bio-aerosols evolved in the breath of
ventilated patients and captured in the hygroscopic condenser humidifier filter of the ventilator circuit contain
pathogenic micro-organisms. 2). The number (CFU/ml) and identity (Genus, species) of the pathogens in the
aerosol samples can rapidly and inexpensively be determined by PCR. 3). Data from a convenience sample of
filters correlate with clinical findings from standard microbiological methods such as broncho-alveolar lavage.
The evaluation of the bacterial load evolved in exhaled breath by PCR is amenable to repeated sampling. Since
increasing bacterial burden is believed to correlate with the establishment of infection, the use of quantitative
PCR may provide a method to rapidly, inexpensively, and effectively detect and diagnose the early onset of
pneumonia and identify pathogens involved. (AJTR1111002).
Keywords: Pneumonia, VAP, BAL, HME, HCH, infection
Full Text PDF
Address all correspondence to:
Dr. Erik M. Boczko
Department of Biomedical Informatics
Vanderbilt University
Nashville, TN 37233, USA.
Phone: (615) 936-6668, Fax:(615) 936-1427
E-mail: erik.boczko@vanderbilt.edu
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