Evaluation of the Polymerase Chain Reaction Method for Detection of Streptococcus pneumoniae DNA in Pleural Fluid Samples

Falguera, Miquel; López, Abraham Meneses; Nogués, A; Porcel, José M.; Rubio-Caballero, Manuel

doi:10.1378/chest.122.6.2212

Cited by 40 publications

(22 citation statements)

References 23 publications

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“…However, the data available are derived from standard culture and immunologic methods, suggesting an underestimation. The PCR detection of S pneumoniae in adult patients with community-acquired pneumonia was positive in 71% of samples that had negative and positive pleural fluid cultures [28].…”

Section: Discussionmentioning

confidence: 98%

Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children

Menezes-Martins

Michaelsen

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 98%

Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children

Menezes-Martins

Michaelsen

et al. 2005

Journal of Pediatric Surgery

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“…PCR detection of causative microorganisms in pleural fluid has been reported previously [17,18,19,20,21], indicating a high sensitivity in the detection of causative agents. The results of the present study show that PCR analysis could increase the diagnostic yield of conventional techniques from 7.1 to 35.7%, highlighting the limitations of standard culture as a diagnostic tool for the etiology in pleural effusions in children.…”

Section: Discussionmentioning

confidence: 99%

Pleural Fluid PCR Method for Detection of <i>Staphylococcus aureus, Streptococcus pneumoniae</i> and <i>Haemophilus influenzae</i> in Pediatric Parapneumonic Effusions

Ütine

Pinar²,

Özçeli̇k³

et al. 2007

Respiration

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Background: Parapneumonic effusions cause significant morbidity and mortality despite current developments in diagnostic and therapeutic approaches. Causative microorganisms may remain unidentified in a significant number of patients by cultures and Gram smears. Polymerase chain reaction (PCR) is a molecular technique for the detection of causative bacteria; however, its efficiency in pleural fluids is less known. Objectives: The present study was performed to compare the efficiency of PCR in the detection of the three most common organisms (Staphylococcus aureus, Streptococcus pneumoniae and Haemophylus influenzae) with conventional methods. Methods: Twenty-eight consecutive patients with parapneumonic pleural effusions were studied. On admission, pleural fluid samples were obtained for Gram staining, routine culture and PCR analysis for S. aureus, S. pneumoniae and H. influenzae. Results: PCR analysis allowed detection of 11 microorganisms in 10 patients (35.7%), whereas pleural fluid cultures detected the etiological agent in only 2 (7.1%). S. pneumoniae was the most frequent agent. Conclusions: Pleural fluid cultures may have low diagnostic yields, partly due to prior antibiotic use. Pleural fluid PCR analysis may improve the etiologic diagnosis in parapneumonic pleural effusions, with technical advances leading to higher yields than obtained in this study.

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“…In addition, blood cultures usually require 1 or 2 days before results are available and thus may have limited impact on the initial choice of empirical antimicrobial treatment (6,29). PCR and antigen detection provide non-culture-based tools for the rapid identification of S. pneumoniae in respiratory tract specimens, pleural aspirate samples, and blood samples (7,8,13). These tests can add to culture methods in the etiological diagnosis of patients with CAP, particularly for patients who received antimicrobial treatment prior to sampling for culture (13,26,33).…”

mentioning

confidence: 99%

Streptococcus pneumoniae DNA Load in Blood as a Marker of Infection in Patients with Community-Acquired Pneumonia

Peters

Boer²,

Schuurman³

et al. 2009

J Clin Microbiol

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Direct detection of Streptococcus pneumoniae DNA in blood adds to culture results in the etiological diagnosis of patients with community-acquired pneumonia (CAP). Quantification of the amount of DNA, the bacterial DNA load (BDL), provides a measurement of DNAemia that may increase the understanding of the clinical relevance of S. pneumoniae DNA in blood. We evaluated the S. pneumoniae BDL as a diagnostic tool in adult patients with CAP. The BDL was determined in whole-blood samples collected simultaneously with blood for culture from 45 adult patients with CAP. After DNA extraction, S. pneumoniae DNA was detected with specific real-time PCR amplification, and the BDL was calculated with a standard curve. PCR and microbiological results were compared, and the BDL was related to clinical and laboratory parameters. S. pneumoniae DNA was detected in 10/13 patients with positive blood cultures and in 67% of patients with microbiologically confirmed pneumococcal pneumonia. The positive predictive values of the receiver operating characteristic curves for the BDLs for pneumococcal infection (100%) and pneumococcal bacteremia (69%) were higher than those for the level of C-reactive protein (CRP; 43% and 23%, respectively) and the white blood cell count (WBC; 42% and 35%, respectively); the negative predictive values of these three parameters were in the same range (؎90 and ؎97%, respectively). The BDL was higher in patients presenting with systemic inflammatory response syndrome and in patients with bacteremia. Positive correlations were observed for the BDL with WBC, CRP level, and length of stay. We conclude that the BDL supports the diagnosis of S. pneumoniae infection in patients with CAP and provides a putative marker of the severity of disease.

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Evaluation of the Polymerase Chain Reaction Method for Detection of Streptococcus pneumoniae DNA in Pleural Fluid Samples

Cited by 40 publications

References 23 publications

Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children

Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children

Pleural Fluid PCR Method for Detection of <i>Staphylococcus aureus, Streptococcus pneumoniae</i> and <i>Haemophilus influenzae</i> in Pediatric Parapneumonic Effusions

Streptococcus pneumoniae DNA Load in Blood as a Marker of Infection in Patients with Community-Acquired Pneumonia

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