Application of real-time quantitative polymerase chain reaction assay to detect Legionella pneumophila in patients of community-acquired pneumonia in a tertiary care hospital

Angrup, Archana; Chaudhry, Rama; Sharma, Sarsij; Valavane, Arvind; Passi, Kapil; Padmaja, K.; Javed, Sabah; Dey, Aparajita; Dhawan, Benu; Kabra, SK

doi:10.4103/0255-0857.195353

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…The analysis identified 17 relevant studies (Figure 1). All 17 studies 10-26 were considered for qualitative as well as the quantitative synthesis of aetiological agents. Ultimately, only 12 of 17 studies were included for S. pneumoniae meta-analysis, 10,13,15,16,18-22,24-26 since the remaining five studies did not include S. pneumoniae among the aetiological agents in their analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Other causative organisms of CAP in the Indian adolescent and adult population were Mycoplasma pneumoniae (1.1%-35.4%), 13,14,17 Klebsiella pneumoniae (1.6%-24.0%), 10,13,15,16,18-22,24-26 Legionella pneumophila (2.5%-23.8%), 11,12 Staphylococcus aureus (1.0%-12.8%), 10,13,15,16,18-22,24-26 Pseudomonas aeruginosa (0.83%-11.6%), 10,13,15,16,18-22,24-26 Escherichia coli (0.83%-8.57%), 10,13,16,18,19,21,22,24-26 Acinetobacter spp. (0.83%-5.0%), 10,13,16,18,19,24,26 and Enterobacter spp.…”

Section: Resultsmentioning

confidence: 99%

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Streptococcus pneumoniae as a Cause of Community-Acquired Pneumonia in Indian Adolescents and Adults: A Systematic Review and Meta-Analysis

Ghia

Dhar

Koul

et al. 2019

Clin Med Insights Circ Respir Pulm Med

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Background: Streptococcus pneumoniae is one of the primary cause of community-acquired pneumonia (CAP) worldwide. However, scant data are available on the prevalence of etiological organisms for CAP in adolescent and adult Indian population. Objective: We performed a systematic review and meta-analysis to determine the contribution of S. pneumoniae in the causation of CAP in Indian patients aged 12 years or above. Methodology: We performed a systematic search of both indexed and non-indexed publications using PubMed, databases of National Institute of Science Communication and Information Resources (NISCAIR), Annotated Bibliography of Indian Medicine (ABIM), Google Scholar, and hand search including cross-references using key terms ‘community acquired pneumonia AND India’. All studies, published between January 1990 and January 2017, that evaluated Indian patients aged above 12 years with a confirmed diagnosis of CAP were eligible for inclusion. Our search retrieved a total of 182 studies, of which only 17 and 12 qualified for inclusion in the systematic review of all etiological organisms, and meta-analysis of S. pneumonia, respectively. Results: A total of 1435 patients met the inclusion criteria. The pooled proportion of patients with S. pneumoniae infection was 19% (95% confidence interval [CI]: 12%-26%; I2 = 94.5% where I2 represents heterogeneity, P < .01). Other major etiological agents are Mycoplasma pneumoniae (15.5% [1.1%-35.5%]), Klebsiella pneumoniae (10.5% [1.6%-24.0%]), and Legionella pneumophila (7.3% [2.5%-23.8%]). Conclusions: Analysis found approximately a one-fifth proportion of adult Indian patients of CAP with S. pneumoniae infection, suggesting it as a leading organism for causing CAP compared with other etiological organisms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Streptococcus pneumoniae as a Cause of Community-Acquired Pneumonia in Indian Adolescents and Adults: A Systematic Review and Meta-Analysis

Ghia

Dhar

Koul

et al. 2019

Clin Med Insights Circ Respir Pulm Med

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“… Gastroenteritis and wound infections [ 57 , 200 , 245 , 246 ] Women Enterohemorrhagic Escherichia coli Hemolytic–uremic syndrome and irritable bowel syndrome [ 59 , 60 ] Respiratory tract infections Men Streptococcus pneumoniae Community-acquired pneumonia [ 79 ] Mycobacterium tuberculosis Tuberculosis [ 93 – 100 ] Legionella spp. Legionnaires’ disease [ 131 , 132 , 141 , 133 – 140 ] Bloodstream infections Men Many bacterial species Septic shock, organ dysfunction, severe sepsis [ 18 , 162 , 177 , 163 , 165 – 167 , 173 – 176 ] Urinary tract infections Women Escherichia coli Acute cystitis, inflammation, and sepsis [ 229 , 231 ] Lyme borreliosis Women Borrelia burgdorferi Erythema migrans and facial nerve palsy [ 232 , 233 ] Sexually transmitted infections Women Chlamydia trachomatis Infertility, ectopic pregnancy, and pelvic inflammatory disease [ 235 , 237 ] Neisseria gonorrhea …”

Section: Introductionmentioning

confidence: 99%

Sexual dimorphism in bacterial infections

et al. 2018

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BackgroundSex differences are important epidemiological factors that impact in the frequency and severity of infectious diseases. A clear sexual dimorphism in bacterial infections has been reported in both humans and animal models. Nevertheless, the molecular mechanisms involved in this gender bias are just starting to be elucidated. In the present article, we aim to review the available data in the literature that report bacterial infections presenting a clear sexual dimorphism, without considering behavioral and social factors.Main bodyThe sexual dimorphism in bacterial infections has been mainly attributed to the differential levels of sex hormones between males and females, as well as to genetic factors. In general, males are more susceptible to gastrointestinal and respiratory bacterial diseases and sepsis, while females are more susceptible to genitourinary tract bacterial infections. However, these incidences depend on the population evaluated, animal model and the bacterial species. Female protection against bacterial infections and the associated complications is assumed to be due to the pro-inflammatory effect of estradiol, while male susceptibility to those infections is associated with the testosterone-mediated immune suppression, probably via their specific receptors. Recent studies indicate that the protective effect of estradiol depends on the estrogen receptor subtype and the specific tissue compartment involved in the bacterial insult, suggesting that tissue-specific expression of particular sex steroid receptors contributes to the susceptibility to bacterial infections. Furthermore, this gender bias also depends on the effects of sex hormones on specific bacterial species. Finally, since a large number of genes related to immune functions are located on the X chromosome, X-linked mosaicism confers a highly polymorphic gene expression program that allows women to respond with a more expanded immune repertoire as compared with men.ConclusionNotwithstanding there is increasing evidence that confirms the sexual dimorphism in certain bacterial infections and the molecular mechanisms associated, further studies are required to clarify conflicting data and to determine the role of specific hormone receptors involved in the gender bias of bacterial infections, as well as their potential as therapeutic targets.

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“…There is a need to prioritize studies on this unexplored pathogen as the rates of ventilator associated pneumonia is fairly larger in India 19,20 . Though conventional culture technique is considered the gold standard for detection, use of molecular techniques like PCR have proven to increase the sensitivity for clinical diagnosis of Legionella [21][22][23][24] . Respiratory equipment like nebulizers and humidifiers have been implicated as sources of Legionella resulting in hospital-acquired Legionellosis.…”

Section: Discussionmentioning

confidence: 99%

Genetic Diversity of the Legionella pneumophila dotA Gene Detected on Surfaces of Respiratory Therapy Equipment

Vittal¹,

Kumar²,

Karunasagar³

et al. 2021

J Pure Appl Microbiol

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Legionellosis is a neglected disease due to the absence of well-defined clinical symptoms and difficulties in isolating the causal organism. Legionella spp. is known to colonize the lumen of respiratory therapy equipment(RTE) and evade conventional detection by entering the viable but non-culturable state. Monitoring these surfaces for Legionella pneumophila in addition to routine monitoring of water could aid in decreasing incidences of hospital-acquired infections by this pathogen. In this study swabs of different respiratory therapy equipment were tested for the presence of Legionella by conventional culture-based methods versus molecular detection of culture-independent template by polymerase chain reaction (PCR). Genetic diversity of the genes amplified were studied using bioinformatic tools. The dotA genes were genetically diverse indicating no clonality. This communication highlights that the persistence of virulence genes like dotA on abiotic surfaces can result in the mobilization of these genes to other species and give rise to virulent forms especially in a healthcare setting.

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Application of real-time quantitative polymerase chain reaction assay to detect Legionella pneumophila in patients of community-acquired pneumonia in a tertiary care hospital

Cited by 6 publications

References 13 publications

Streptococcus pneumoniae as a Cause of Community-Acquired Pneumonia in Indian Adolescents and Adults: A Systematic Review and Meta-Analysis

Streptococcus pneumoniae as a Cause of Community-Acquired Pneumonia in Indian Adolescents and Adults: A Systematic Review and Meta-Analysis

Sexual dimorphism in bacterial infections

Genetic Diversity of the Legionella pneumophila dotA Gene Detected on Surfaces of Respiratory Therapy Equipment

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