Acute and Critical Care

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

624 View
50 Download

Abstract PDF 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
Incidence and risk factors associated with progression to severe pneumonia among adults with non-severe Legionella pneumonia: Jin-Young Huh, Sang-Ho Choi, Kyung-Wook Jo, Jin Won Huh, Sang-Bum Hong, Tae Sun Shim, Chae-Man Lim, Younsuck Koh; Acute Crit Care. 2022;37(4):543-549. Published online October 21, 2022; DOI: https://doi.org/10.4266/acc.2022.00521

8,264 View
149 Download
6 Web of Science
6 Crossref

Background
Legionella species are important causative organisms of severe pneumonia. However, data are limited on predictors of progression to severe Legionella pneumonia (LP). Therefore, the risk factors for LP progression from non-severe to the severe form were investigated in the present study.
Methods
This was a retrospective cohort study that included adult LP patients admitted to a 2,700-bed referral center between January 2005 and December 2019.
Results
A total of 155 patients were identified during the study period; 58 patients (37.4%) initially presented with severe pneumonia and 97 (62.6%) patients with non-severe pneumonia. Among the 97 patients, 28 (28.9%) developed severe pneumonia during hospitalization and 69 patients (71.1%) recovered without progression to severe pneumonia. Multivariate logistic regression analysis showed platelet count ≤150,000/mm3 (odds ratio [OR], 2.923; 95% confidence interval [CI], 1.100–8.105; P=0.034) and delayed antibiotic treatment >1 day (OR, 3.092; 95% CI, 1.167–8.727; P=0.026) were significant independent factors associated with progression to severe pneumonia.
Conclusions
A low platelet count and delayed antibiotic treatment were significantly associated with the progression of non-severe LP to severe LP.

Citations

Citations to this article as recorded by

Understanding the Correlation between Blood Profile and the Duration of Hospitalization in Pediatric Bronchopneumonia Patients: A Cross-Sectional Original Article
Dessika Listiarini, Dev Desai, Yanuar Wahyu Hidayat, Kevin Alvaro Handoko
The Journal of Critical Care Medicine.2024; 10(3): 254. CrossRef
An Investigation of Mortality Associated With Comorbid Pneumonia and Thrombocytopenia in a Rural Southwest Missouri Hospital System
Tabitha Ranson , Hannah Rourick , Rajbir Sooch , Nicole Ford, Nova Beyersdorfer, Kerry Johnson, John Paulson
Cureus.2024;[Epub] CrossRef
Legionella Pneumonia Undetected by Repeated Urinary Antigen Testing With Ribotest® Legionella
Yasushi Murakami, Mika Morosawa, Yasuhiro Nozaki, Yoshio Takesue
Cureus.2024;[Epub] CrossRef
Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia
Elliott Worku, Dominic Adam Worku, Salim Surani
Case Reports in Infectious Diseases.2023; 2023: 1. CrossRef
Short- and long-term prognosis of patients with community-acquired Legionella or pneumococcal pneumonia diagnosed by urinary antigen testing
Leyre Serrano, Luis Alberto Ruiz, Silvia Perez-Fernandez, Pedro Pablo España, Ainhoa Gomez, Beatriz Gonzalez, Ane Uranga, Sonia Castro, Milagros Iriberri, Rafael Zalacain
International Journal of Infectious Diseases.2023; 134: 106. CrossRef
Case report: Fatal Legionella infection diagnosed via by metagenomic next-generation sequencing in a patient with chronic myeloid leukemia
Chunhong Bu, Shuai Lei, Linguang Chen, Yanqiu Xie, Guoli Zheng, Liwei Hua
Frontiers in Medicine.2023;[Epub] CrossRef

Case Report

Infection
Septic Shock due to Unusual Pathogens, Comamonas testosteroni and Acinetobacter guillouiae in an Immune Competent Patient: Hyun Jung Kim, Yunkyoung Lee, Kyunghwan Oh, Sang-Ho Choi, Heungsup Sung, Jin Won Huh; Korean J Crit Care Med. 2015;30(3):180-183. Published online August 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.3.180

24,764 View
97 Download
7 Crossref

Abstract PDF

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.

Citations

Citations to this article as recorded by

Beyond Bioremediation: A Rare Case of Comamonas testosteroni Bloodstream Infection in a Patient With Stage 5 Chronic Kidney Disease on Maintenance Hemodialysis
Syeda Bushra Fatima, Moiz Ahmed Khan, Summaya Zafar
Seminars in Dialysis.2026;[Epub] CrossRef
An investigation of clinical characteristics and antimicrobial agent susceptibility patterns in clinical Comamonas testosteroni isolates: An increasingly prevalent nosocomial pathogen
Bahadır Orkun Ozbay, Adalet Aypak, Aliye Bastug, Ömer Aydos, İpek Mumcuoglu, Sevim Gayenur Büyükberber, Ayşe Müge Karcıoğlu, Hurrem Bodur
Infectious Diseases Now.2023; 53(2): 104622. CrossRef
Bullfrogs (Lithobates catesbeianus) as a Potential Source of Foodborne Disease
Andrea P. Zepeda-Velazquez, Fabián-Ricardo Gómez-De-Anda, Luis F. Aguilar-Mendoza, Nayeli Shantal Castrejón-Jiménez, Juan Carlos Hernández-González, Jorge A. Varela-Guerrero, Jorge-Luis de-la-Rosa-Arana, Vicente Vega-Sánchez, Nydia E. Reyes-Rodríguez
Journal of Food Protection.2023; 86(4): 100067. CrossRef
The Emergence of the Genus Comamonas as Important Opportunistic Pathogens
Michael P. Ryan, Ludmila Sevjahova, Rachel Gorman, Sandra White
Pathogens.2022; 11(9): 1032. CrossRef
A rare case of peritoneal dialysis‐associated peritonitis caused by Comamonas testosteroni
Roman Kuźniewicz, Mirosław Śnit, Dariusz Szczyra
Seminars in Dialysis.2022; 35(6): 556. CrossRef
The complex pattern of codon usage evolution in the family Comamonadaceae
Eugenio Jara, María A. Morel, Guillermo Lamolle, Susana Castro-Sowinski, Diego Simón, Andrés Iriarte, Héctor Musto
Ecological Genetics and Genomics.2018; 6: 1. CrossRef
First microbiota assessments of children's paddling pool waters evaluated using 16S rRNA gene-based metagenome analysis
Toko Sawabe, Wataru Suda, Kenshiro Ohshima, Masahira Hattori, Tomoo Sawabe
Journal of Infection and Public Health.2016; 9(3): 362. CrossRef

First
Prev
Page of 1
Next
Last

Search