Improvement of pneumococcal pneumonia diagnostics by the use of rt-PCR on plasma and respiratory samples. (October 2013)

• Record Type: Journal Article
• Authors: Cvitkovic Spik, Vesna; Beovic, Bojana; Pokorn, Marko; Drole Torkar, Ana; Vidmar, Darja; Papst, Lea; Seme, Katja; Kogoj, Rok; Müller Premru, Manica
• Is Part Of: Scandinavian journal of infectious diseases. Volume 45:Number 10(2013:Oct.)
• Page Start: 731
• Page End: 737
• Publication Date: 2013-10
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.3109/00365548.2013.804631
• Languages: English
• ISSNs: 0036-5548

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background:</italic> The aim of the study was to assess the performance of a real-time polymerase chain reaction (rt-PCR) assay on plasma and respiratory samples for the diagnosis of pneumococcal pneumonia.</p> <p> <italic>Methods:</italic> Three hundred and forty patients (160 children and 180 adults) with community-acquired pneumonia were included prospectively from January 2011 to May 2012. Blood samples were obtained simultaneously for culture and rt-PCR targeting the <italic>lytA</italic> gene. Respiratory samples were also obtained: nasopharyngeal swab in nearly all patients and sputum or tracheal aspirate when available.</p> <p> <italic>Results:</italic> Streptococcus pneumoniae was detected in 222 (65%) of 340 patients: 143 (89%) children and 79 (44%) adults. Pneumonia was assigned as definite pneumococcal in 96 (28.2%) of 340 patients, according to S. pneumoniae detected in blood: in 54 (33.8%) children – by rt-PCR in 51 (31.9%) and by culture in 5 (3.1%); and in 42 (23.3%) adults – by rt-PCR in 41 (22.8%) and by culture in 12 (6.7%). Pneumonia was considered as probably pneumococcal in 19 (10.6%) adults according to S. pneumoniae detected in sputum/tracheal aspirate, by rt-PCR in 19 and by culture in 5. In 18 adults and 89 children with S. pneumoniae detected only in the nasopharynx, pneumonia was considered as possibly pneumococcal; however it should be noted that nasopharyngeal colonization with S. pneumoniae is also common in children with other aetiologies of pneumonia.</p> <p> <italic>Conclusions:</italic> rt-PCR on plasma and other samples performed significantly better than culture for the detection of pneumococcal pneumonia (<italic>p</italic> < 0.0005) in children and adults.</p> </abstract>