Heping Wang1,2, Jiali Gu1, Xiaonan Li1, Christa E van der Gaast-de Jongh2, Wenjian Wang1, Xuehui He2, Zhi Xu3, Yonghong Yang1, Ronald de Groot2, Marien I de Jonge4, Yuejie Zheng5. 1. Shenzhen Children's Hospital, No. 7019 Yitian Road, Futian District, Shenzhen, 518038, Guangdong, China. 2. Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud university medical center, Philips van Leydenlaan 15, 6525 EX, Nijmegen, The Netherlands. 3. Ningbo Health Gene Technologies Co., Ltd., Ningbo, Zhejiang, China. 4. Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases, Radboud university medical center, Philips van Leydenlaan 15, 6525 EX, Nijmegen, The Netherlands. Marien.DeJonge@radboudumc.nl. 5. Shenzhen Children's Hospital, No. 7019 Yitian Road, Futian District, Shenzhen, 518038, Guangdong, China. yuejiez@sina.com.
Abstract
BACKGROUND: Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms. METHODS: BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified. RESULTS: The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens. CONCLUSION: Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.
BACKGROUND: Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms. METHODS: BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified. RESULTS: The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1infectedpatients was more frequent (49.43%) than in patientsinfected with other pathogens. CONCLUSION: Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.
Authors: Wen Kuan Liu; Qian Liu; De Hui Chen; Huan Xi Liang; Xiao Kai Chen; Mei Xin Chen; Shu Yan Qiu; Zi Yeng Yang; Rong Zhou Journal: PLoS One Date: 2014-05-05 Impact factor: 3.240
Authors: Amparo Escribano Montaner; Juan García de Lomas; José Ramón Villa Asensi; Oscar Asensio de la Cruz; Olga de la Serna Blázquez; Mikel Santiago Burruchaga; Pedro Mondéjar López; Alba Torrent Vernetta; Yang Feng; Melissa K Van Dyke; Janet Reyes; Pilar Garcia-Corbeira; Carla A Talarico Journal: Eur J Pediatr Date: 2017-12-29 Impact factor: 3.183
Authors: Danielle F Wurzel; Julie M Marchant; Julia E Clark; Ian M Mackay; Claire Y T Wang; Theo P Sloots; John W Upham; Stephanie T Yerkovich; I Brent Masters; Peter J Baker; Sophie Anderson-James; Anne B Chang Journal: J Clin Virol Date: 2013-09-23 Impact factor: 3.168