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Acta Paediatr. 2013 Feb 19. doi: 10.1111/apa.12207. [Epub ahead of print]
Polymerase-Chain-Reaction-Based Diagnosis of Viral Pulmonary Infections in Immunocompromised Children.
Kadmon G, Levy I, Mandelboim M, Nahum E, Stein J, Dovrat S, Schonfeld T.
Source
Pediatric Intensive Care Unit, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
Abstract
AIM:
Viral pneumonia is a serious complication in immunocompromised children. Its etiology is difficult to identify owing to the limitations of conventional microbiological tests. The aim of this study was to determine whether polymerase chain reaction (PCR) assays for respiratory viruses increase the diagnostic yield of bronchoalveolar lavage (BAL) in immunocompromised children.
METHODS:
BAL samples obtained from immunocompromised children hospitalized with pneumonia were processed for respiratory viruses by viral culture, rapid antigen test, and PCR (for CMV, adenovirus, influenza, parainfluenza, herpesvirus, RSV and hMPV).
RESULTS:
The study group included 42 patients (mean age 7.2?5.1 years) with 50 episodes of clinical pneumonia (50 BAL samples). Forty viral pathogens were identified in 30 episodes (60%). PCR increased the diagnostic rate by fourfold (75% identified by PCR alone, p<0.0001). When viral culture and rapid antigen test were used as the gold standard, PCR was found to have high sensitivity (86-100% when assessed) and specificity (80-96%). The PCR results prompted the initiation of specific anti-viral therapy and the avoidance of unnecessary antibiotic treatment in 17 (34%) episodes.
CONCLUSION:
PCR-based diagnosis from BAL may increase the rate of pathogen detection in immunocompromised children, decrease the time to diagnosis and spare patients unnecessary antimicrobial treatment. ?2013 The Author(s)/Acta Paediatrica ?2013 Foundation Acta Paediatrica.
?2013 The Author(s)/Acta Paediatrica ?2013 Foundation Acta Paediatrica.
PMID:
23421914
[PubMed - as supplied by publisher]
Polymerase-Chain-Reaction-Based Diagnosis of Viral Pulmonary Infections in Immunocompromised Children.
Kadmon G, Levy I, Mandelboim M, Nahum E, Stein J, Dovrat S, Schonfeld T.
Source
Pediatric Intensive Care Unit, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
Abstract
AIM:
Viral pneumonia is a serious complication in immunocompromised children. Its etiology is difficult to identify owing to the limitations of conventional microbiological tests. The aim of this study was to determine whether polymerase chain reaction (PCR) assays for respiratory viruses increase the diagnostic yield of bronchoalveolar lavage (BAL) in immunocompromised children.
METHODS:
BAL samples obtained from immunocompromised children hospitalized with pneumonia were processed for respiratory viruses by viral culture, rapid antigen test, and PCR (for CMV, adenovirus, influenza, parainfluenza, herpesvirus, RSV and hMPV).
RESULTS:
The study group included 42 patients (mean age 7.2?5.1 years) with 50 episodes of clinical pneumonia (50 BAL samples). Forty viral pathogens were identified in 30 episodes (60%). PCR increased the diagnostic rate by fourfold (75% identified by PCR alone, p<0.0001). When viral culture and rapid antigen test were used as the gold standard, PCR was found to have high sensitivity (86-100% when assessed) and specificity (80-96%). The PCR results prompted the initiation of specific anti-viral therapy and the avoidance of unnecessary antibiotic treatment in 17 (34%) episodes.
CONCLUSION:
PCR-based diagnosis from BAL may increase the rate of pathogen detection in immunocompromised children, decrease the time to diagnosis and spare patients unnecessary antimicrobial treatment. ?2013 The Author(s)/Acta Paediatrica ?2013 Foundation Acta Paediatrica.
?2013 The Author(s)/Acta Paediatrica ?2013 Foundation Acta Paediatrica.
PMID:
23421914
[PubMed - as supplied by publisher]
