Use of multiplex molecular respiratory panel in COVID-19 patients with suspected co-infections Insights and considerations in results interpretation

Nawi AS; Engku Abd Rahman ENS; Nik Zuraina NMN; Musa N; Salleh MZ; Samsudin MNF; Chua WC; Muhd Besari A; Hassan R; Chan YY

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Use of multiplex molecular respiratory panel in COVID-19 patients with suspected co-infections Insights and considerations in results interpretation

Author: Nawi A.S. ¹ ; Engku Abd Rahman E.N.S. ² ; Nik Zuraina N.M.N. ² ; Musa N. ³ ; Salleh M.Z. ² ; Samsudin M.N.F. ² ; Chua W.C. ² ; Muhd Besari A. ⁴ ; Hassan R. ; Chan Y.Y. ²
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1. Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
2. Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
3. Human Genome Center, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
4. Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia;
Publication Type:Journal Article
Keywords: SARS-CoV-2; COVID-19; co-detection; co-infection; respiratory pathogen.
From:Tropical Biomedicine 2025;42(No. 1):21-26
CountryMalaysia
Language:English
Abstract: As critically ill COVID-19 patients are prone to infections by other respiratory pathogens, this study aimed to investigate the detection of respiratory co-pathogens in such patients, by employing a multiplex respiratory molecular panel. Conducted at Universiti Sains Malaysia Specialist Hospital (HPUSM) from November 1, 2021, to November 1, 2022, this retrospective cross-sectional study analysed adults admitted with confirmed COVID-19. Oropharyngeal/ nasopharyngeal swabs collected upon admission were tested using the Fast Track Diagnostic (FTD®) Respiratory Pathogens 33 multiplex kit to detect other respiratory pathogens. Within 48 hours of admission, the presence and type of organisms were determined to assess community co-infections. Among 48 critically ill COVID-19 patients (26 male; mean age, 62.2 years), clinically significant organisms were found in 32 patients (67%). Bacterial co-infections or co-colonization were detected in 91% (29/32) of these patients, with Klebsiella pneumoniae (40%) and Staphylococcus aureus (23%) were the most common, followed by Streptococcus pneumoniae (11%), Moraxella catarrhalis (4%), and Haemophilus influenzae (2%). Fungal (6%) and viral (2%) co-infections were less frequent. The use of syndromic respiratory panel in critically ill COVID-19 patients offers the advantage of being highly sensitive, rapid, and able to detect multiple pathogens. However, detection of multiple respiratory pathogens needs to be interpreted with caution, taking into consideration patient’s clinical and radiological findings, as well as quantitative molecular data.
Full text:202608201252312437Use of multiplex molecular respiratory panel in COVID-19 patients with.pdf