Identifying pneumococci in parapneumonic pleural effusion: Is there a role for culture-independent methods?
Pediatr Pulmonol
; 55(2): 484-489, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31738021
ABSTRACT
OBJECTIVE:
To evaluate culture-independent procedures (immunochromatography and quantitative polymerase chain reaction [qPCR]) in the detection and susceptibility of Streptococcus pneumoniae directly from culture-negative pleural fluid (PF) in children.METHOD:
Detection of S. pneumoniae in PF of children with parapneumonic effusion and/or empyema by using two culture-independentmethods:
an immunochromatographic membrane test (IMT) which identifies the pneumococcal C antigen, and a real-time PCR test to detect pneumococcal genes lytA and pbp2b, a marker of susceptibility of ß-lactam agents, in PF samples.RESULTS:
We tested 36 PF specimens and recorded the previous use of antimicrobials. In the final analysis, 34 samples were included. IMT and qPCR presented positive results in 23 (67.6%) and 24 (70.6%) of the samples, respectively, showing a moderate agreement (k = 0.518) between the two methods. From the 36 children included, 34 (94.4%) had antibiotic data available by the time when PFs were collected. Thirty-four (100%) children had been given treatment before PF sampling, with 33 (97%) receiving ß-lactam antibiotics administered empirically. Of the 24 lytA real-time positive samples, 21 (87.5%) were also positive for pbp2b, a marker of ß-lactam susceptibility.CONCLUSION:
The reduced sensitivity of culture for pneumococcal detection can be improved through the addition of IMT and qPCR analysis. The utility of qPCR combining detection of lytA and a marker of ß-lactam susceptibility should be explored further.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derrame Pleural
/
Streptococcus pneumoniae
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article