STUDY OBJECTIVE: Streptococcus pneumoniae is the most frequent causative agent of community-acquired pneumonia (CAP); however, an etiologic diagnosis by traditional techniques can be accomplished in only a small percentage of patients with CAP. Pleural fluid is present in approximately 40% of patients with CAP; therefore, we hypothesized that detection of S pneumoniae DNA in pleural fluid by polymerase chain reaction (PCR) may help to increase the rate of diagnosis of pneumococcal pneumonia. DESIGN: A prospective study of cases. SETTING: A university hospital in Lleida, Spain. PATIENTS AND METHODS: One hundred two samples of pleural fluid (51 samples from consecutive adult patients with pneumonia and 51 samples from unselected control subjects) were tested by the nested-PCR method to detect selected pneumolysin gene of S pneumoniae, and the results were compared with those provided by alternative diagnostic methods. RESULTS: PCR in pleural fluid had a diagnostic sensitivity of 78% in patients with pneumococcal pneumonia, with positive results in 2 of 2 patients (100%) and 5 of 7 patients (71%) who had positive or negative pleural fluid culture findings, respectively. PCR results were also positive in 3 of 24 patients (12%) with pneumonia of unknown etiology and negative in all patients with pneumonia due to microorganisms other than S pneumoniae. Thus, the calculated specificity was 93%. Among control subjects, PCR gave positive results in two cases (4%). CONCLUSION: The nested-PCR test, applied to pleural fluid samples from patients with CAP, showed a sensitivity of 78% and a specificity of 93% in the diagnosis of pneumococcal pneumonia.
STUDY OBJECTIVE:Streptococcus pneumoniae is the most frequent causative agent of community-acquired pneumonia (CAP); however, an etiologic diagnosis by traditional techniques can be accomplished in only a small percentage of patients with CAP. Pleural fluid is present in approximately 40% of patients with CAP; therefore, we hypothesized that detection of S pneumoniae DNA in pleural fluid by polymerase chain reaction (PCR) may help to increase the rate of diagnosis of pneumococcal pneumonia. DESIGN: A prospective study of cases. SETTING: A university hospital in Lleida, Spain. PATIENTS AND METHODS: One hundred two samples of pleural fluid (51 samples from consecutive adult patients with pneumonia and 51 samples from unselected control subjects) were tested by the nested-PCR method to detect selected pneumolysin gene of S pneumoniae, and the results were compared with those provided by alternative diagnostic methods. RESULTS: PCR in pleural fluid had a diagnostic sensitivity of 78% in patients with pneumococcal pneumonia, with positive results in 2 of 2 patients (100%) and 5 of 7 patients (71%) who had positive or negative pleural fluid culture findings, respectively. PCR results were also positive in 3 of 24 patients (12%) with pneumonia of unknown etiology and negative in all patients with pneumonia due to microorganisms other than S pneumoniae. Thus, the calculated specificity was 93%. Among control subjects, PCR gave positive results in two cases (4%). CONCLUSION: The nested-PCR test, applied to pleural fluid samples from patients with CAP, showed a sensitivity of 78% and a specificity of 93% in the diagnosis of pneumococcal pneumonia.
Authors: María del Mar García-Suárez; María Dolores Cima-Cabal; Roberto Villaverde; Emma Espinosa; Miquel Falguera; Juan R de Los Toyos; Fernando Vázquez; Francisco J Méndez Journal: J Clin Microbiol Date: 2007-08-29 Impact factor: 5.948
Authors: Remco P H Peters; Richard F de Boer; Tim Schuurman; Sonja Gierveld; Mirjam Kooistra-Smid; Michiel A van Agtmael; Christina M J E Vandenbroucke-Grauls; Maike C J Persoons; Paul H M Savelkoul Journal: J Clin Microbiol Date: 2009-08-12 Impact factor: 5.948
Authors: P Zak; E Vejrazkova; A Zavrelova; L Pliskova; L Ryskova; P Hubacek; V Stepanova; M Kostal; V Koblizek; P Paterova; Jakub Radocha Journal: Folia Microbiol (Praha) Date: 2019-05-09 Impact factor: 2.099