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Identification of pathogens by comprehensive real-time PCR versus conventional methods in community-acquired pneumonia in Japanese adults.

Identification of pathogens by comprehensive real-time PCR versus conventional methods in community-acquired pneumonia in Japanese adults.

Authors :
Yoshii, Yutaka
Shimizu, Kenichiro
Morozumi, Miyuki
Chiba, Naoko
Ubukata, Kimiko
Uruga, Hironori
Hanada, Shigeo
Wakui, Hiroshi
Ito, Saburo
Takasaka, Naoki
Minagawa, Shunsuke
Kojima, Jun
Numata, Takanori
Hara, Hiromichi
Kawaishi, Makoto
Saito, Keisuke
Araya, Jun
Kaneko, Yumi
Nakayama, Katsutoshi
Kishi, Kazuma
Source :
Infectious Diseases; Nov/Dec2016, Vol. 48 Issue 11/12, p782-788, 7p, 3 Charts, 1 Graph
Publication Year :
2016

Abstract

Background:Community-acquired pneumonia (CAP) has high morbidity and mortality. Unfortunately, the pathogen detection rate using conventional culture methods is relatively low. We compared comprehensive real-time polymerase chain reaction (real-time PCR) analysis of nasopharyngeal swab specimens (NPS) and sputum samples against conventional methods for ability to detect causative pathogens of CAP. Methods:We prospectively enrolled adult CAP patients, including those with prior antibiotic use, from December 2012 to May 2014. For each patient, causative pathogens were investigated conventionally and by real-time PCR that can identify 6 bacterial and 11 viral pathogens. Results:Patients numbered 92 (mean age, 63 years; 59 male), including 30 (33%) with prior antibiotic use. Considering all patients, identification of causative pathogens by real-time PCR was significantly more frequent than by conventional methods in all patients (72% vs. 57%,p = 0.018). In patients with prior antibiotic use, identification rates also differed significantly (PCR, 77%; conventional, 50%;p = 0.027). Mixed infections were more frequent according to real-time PCR than conventional methods (26% vs. 4%,p < 0.001). By the real-time PCR,Streptococcus pneumoniaewas most frequently identified (38%) as a causative pathogen, followed byHaemophilus influenzae(37%) andMycoplasma pneumoniae(5%). PCR also identified viral pathogens (21%), with sensitivity enhanced by simultaneous examination of both NPS and sputum samples rather than only NPS samples. Conclusions:Real-time PCR of NPS and sputum samples could better identify bacterial and viral pathogens in CAP than conventional methods, both overall and in patients with prior antibiotic treatment. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
23744235
Volume :
48
Issue :
11/12
Database :
Complementary Index
Journal :
Infectious Diseases
Publication Type :
Academic Journal
Accession number :
118090755
Full Text :
https://doi.org/10.1080/23744235.2016.1193788