Comprehensive detection of causative pathogens using real-time PCR to diagnose pediatric community-acquired pneumonia

J Infect Chemother. 2008 Dec;14(6):424-32. doi: 10.1007/s10156-008-0648-6. Epub 2008 Dec 17.

Abstract

We have developed a real-time reverse transcription-PCR (RT-PCR) method to detect 13 respiratory viruses: influenza virus A and B; respiratory syncytial virus (RSV) subgroup A and B; parainfluenza virus (PIV) 1, 2, and 3; adenovirus; rhinovirus (RV); enterovirus; coronavirus (OC43); human metapneumovirus (hMPV); and human bocavirus (HBoV). The new method for detection of these viruses was applied simultaneously with real-time PCR for the detection of six bacterial pathogens in clinical samples from 1700 pediatric patients with community-acquired pneumonia (CAP). Of all the patients, 32.5% were suspected to have single bacterial infections; 1.9%, multiple bacterial infections; 15.2%, coinfections of bacteria and viruses; 25.8%, single viral infections; and 2.1%, multiple viral infections. In the remaining 22.6%, the etiology was unknown. The breakdown of suspected causative pathogens was as follows: 24.4% were Streptococcus pneumoniae, 14.8% were Mycoplasma pneumoniae, 11.3% were Haemophilus influenzae, and 1.4% were Chlamydophila pneumoniae. The breakdown of viruses was as follows: 14.5% were RV, 9.4% were RSV, 7.4% were hMPV, 7.2% were PIV, and 2.9% were HBoV. The new method will contribute to advances in the accuracy of diagnosis and should also result in the appropriate use of antimicrobials.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Community-Acquired Infections / diagnosis*
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / virology
  • DNA Viruses / classification
  • DNA Viruses / genetics
  • DNA Viruses / isolation & purification
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / genetics
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Cocci / classification
  • Gram-Positive Cocci / genetics
  • Gram-Positive Cocci / isolation & purification
  • Humans
  • Infant
  • Infant, Newborn
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / virology
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / virology
  • Polymerase Chain Reaction / methods*
  • RNA Viruses / classification
  • RNA Viruses / genetics
  • RNA Viruses / isolation & purification
  • Sensitivity and Specificity
  • Young Adult