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Original Articles
- Pulmonary
- Real-world experience using multiplex polymerase chain reaction in intensive care unit patients with hospital-acquired and ventilator-associated pneumonia in South Korea
- Eun Chong Yoon, Sang-Ho Choi, Heungsup Sung, Yong Pil Chong, Euijin Chang, Kyung-Hyun Do, Su Yeon Lee, Dong-gon Hyun, Jee Hwan Ahn, Jin Won Huh, Chae-Man Lim, Sang-Bum Hong
- Acute Crit Care. 2026;41(1):87-96. Published online February 27, 2026
- DOI: https://doi.org/10.4266/acc.005100
- 1,261 View
- 80 Download
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Abstract
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Supplementary Material - Background
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are common among critically ill patients, leading to increased morbidity and mortality rates. Conventional culture-based diagnostics require 48–72 hours, which delays pathogen identification and prolongs the use of broad-spectrum antibiotics. Multiplex polymerase chain reaction (mPCR) enables the rapid detection of pathogens and resistance genes, but its effects on real-world antibiotic decision-making remain unclear.
Methods
This retrospective study included patients in the intensive care unit who were diagnosed with HAP or VAP at a tertiary medical center between July 2023 and June 2024. All patients underwent both mPCR and respiratory culture. The primary outcome was the time to the first antibiotic modification based on mPCR or respiratory culture. The secondary outcome was the rate of antibiotic de-escalation from carbapenem or teicoplanin/vancomycin based on mPCR findings.
Results
In total, 75 patients were included (median age, 68 years; 61.3% male). mPCR identified bacterial pathogens in 45.3% cases, with a median turnaround time of 281 minutes. The median time to antibiotic modification was 5.8 hours for mPCR versus 122.32 hours for culture (P<0.01). Despite negative mPCR results for gram-negative bacilli, carbapenem therapy was discontinued in only 1 of 24 cases (4.2%). Among 39 patients with negative results for Staphylococcus aureus, vancomycin or teicoplanin was discontinued in only 3 cases (7.7%).
Conclusions
mPCR provided faster pathogen identification and earlier antibiotic modifications than conventional respiratory culture. However, antibiotic discontinuation remained uncommon despite negative mPCR results, highlighting challenges in real-world antimicrobial stewardship.
- Pulmonary
- Characteristics and management of mechanically ventilated patients in South Korea compared with other high-income Asian countries and regions
- Kyung Hun Nam, Kyeongman Jeon, Suk-Kyung Hong, Ah Young Leem, Jee Hwan Ahn, Hang Jea Jang, Ki Sup Byun, So Hee Park, Sojung Park, Yoon Mi Shin, Jisoo Park, Sung Wook Kang, Jin Hyoung Kim, Jinkyeong Park, Deokkyu Kim, Bo young Lee, Woo Hyun Cho, Kwangha Lee, Song I Lee, Tai Sun Park, Yun Jung Jung, Sang-Hyun Kwak, Sang-Beom Jeon, Sung Hyun Kim, Won Jai Jung, Sang-Min Lee, Sunghoon Park, Yun Su Sim, Young-Jae Cho, Younsuck Koh
- Acute Crit Care. 2025;40(3):413-424. Published online August 21, 2025
- DOI: https://doi.org/10.4266/acc.003336
- 4,071 View
- 111 Download
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Abstract
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- Background
This study investigated the characteristics of mechanically ventilated patients in South Korean intensive care units (ICUs). Methods: We conducted a subgroup analysis of a multinational observational study. Data from 271 mechanically ventilated patients in South Korean ICUs were analyzed for demographics, ventilation practices, and mortality, and were compared with those of 327 patients from other high-income Asian countries. Results: South Korean patients were older (mean age: 67 vs. 62 years, P<0.001) and had lower ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (255.5 vs. 306.2, P<0.001). South Korean ICUs exhibited higher patient-to-nurse ratios (2.6 vs. 1.9, P<0.001) and more beds per unit (20.5 vs. 16.0, P=0.017). The use of sufficient positive end-expiratory pressure for patients (PEEP) for acute respiratory distress syndrome (ARDS) was less frequent in South Korea (62.2% vs. 91.2%, P=0.005). Mortality rates were similar between South Korean patients and those in other high-income Asian countries (38.0% vs. 34.2%, P=0.401). Significant mortality predictors in South Korea included age ≥65 years (odds ratio [OR], 4.03; P=0.039) and a Sequential Organ Failure Assessment score ≥8 (OR, 2.36; P=0.031). The presence of respiratory therapists was associated with reduced mortality (OR, 0.52; P=0.034). Conclusions: Despite higher age and patient-to-nurse ratios in South Korean ICUs, outcomes were comparable to those in other high-income Asian countries. The suboptimal use of sufficient PEEP with ARDS indicates potential areas for improvement. Additionally, the beneficial impact of respiratory therapists on mortality rates warrants further investigation.
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