HIRA-TAN: A real-time PCR-based system for the rapid identification of causative agents in pneumonia

Takashi Hirama, Shohei Minezaki, Takefumi Yamaguchi, Etsuko Kishi, Keiji Kodama, Hiroshi Egashira, Kunihiko Kobayashi, Makoto Nagata, Toshiaki Ishii, Manabu Nemoto, Masahiko Tanaka, Koichi Fukunaga, Minoru Kanazawa, Koichi Hagiwara

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Identification of the causative pathogen(s) of pneumonia would allow the selection of effective antibiotics and thus reduce the mortality rate and the emergence of drug-resistant pathogens. To identify such pathogens and to obtain these benefits, it is necessary that a clinical test is rapid, accurate, easily performed, and cost-effective. Here, we devised a PCR-based test, named HIRA-TAN, which is able to discriminate therapeutic targets from commensal organisms (e.g. Streptococcus pneumoniae or Haemophilus influenzae) and to detect foreign organisms (e.g. Mycoplasma pneumoniae or Legionella pneumophila) in the sputum. The utility of this system was validated in a prospective study, using sputum samples from patients with pneumonia. 568 patients were enrolled and the HIRA-TAN assay identified the causative pathogens with an accuracy of 96.7% for H. influenzae; 93.2% for Pseudomonas aeruginosa; 80.6% for Klebsiella pneumoniae; 90.9% for Moraxella catarrhalis; 87.5% for Escherichia coli; 78.1% for MRSA and 91.6% for S. pneumoniae. Overall the HIRA-TAN procedure was able to identify the causative pathogens of pneumonia in 60% of the cases. Additionally, this procedure was able to determine when the pneumonia-causing organism was a commensal organism or a foreign organism in a single assay. The HIRA-TAN approach yielded reproducible results and provided valuable information to plan the course of treatment of pneumonia. Through the rapid identification of the causative pathogens, the HIRA-TAN will promote targeted treatments for pneumonias. Clinical Trials Registration: UMIN000001694.

Original languageEnglish
Pages (from-to)395-404
Number of pages10
JournalRespiratory Medicine
Issue number2
Publication statusPublished - 2014 Feb


  • Commensal organism
  • Foreign organism
  • Pneumonia
  • Real-time PCR

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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