Improved Diagnosis of the Etiology of Community-Acquired Pneumonia with Real-Time Polymerase Chain Reaction

Templeton, Kate; Scheltinga, Sitha A.; Eeden, Willian C. J. F. M. van den; Graffelman, W.; Broek, P.J. van den; Claas, Eric C. J.

doi:10.1086/431588

Cited by 292 publications

(307 citation statements)

References 42 publications

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“…For instance, some (but not all) studies included in our meta-analysis showed higher severity of pneumonia with bacterial and viral co-infection [1,20]. The interaction seems particularly relevant with rhinovirus [1,8] and influenza [44].…”

Section: Discussionmentioning

confidence: 76%

“…The most commonly identified viruses were influenza in 18 studies [3, 6, 7, 10, 11, 17-19, 21, 23, 26, 27, 29, 31, 32, 34-36], rhinovirus in eight studies [1,5,8,12,22,24,25,28], respiratory syncytial virus in three studies [2,9,33] and coronavirus in two studies [20,30]. Meta-analyses revealed that the proportion of infection by influenza (31 studies) was 8% (95% CI 6.3-9.6%; I 2 =91.9%), by rhinovirus (25 studies) was 5.7% (95% CI 4.3-7.1%; I 2 =90.3%), by respiratory syncytial virus (29 studies) was 2.2% (95% CI 1.6-2.8%; I 2 =80%) and by coronavirus (18 studies) was 3.3% (95% CI 2.3-4.2%; I 2 =80.2%).…”

Section: Individual Virusesmentioning

confidence: 99%

“…New diagnostic techniques have shed a light on the role of viruses as a cause of CAP. The advent of PCR has greatly improved the identification of viruses in patients with CAP [1]. Over the last decade, several studies have used PCR to establish the importance of viruses in the aetiology of CAP [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

et al. 2016

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The advent of PCR has improved the identification of viruses in patients with communityacquired pneumonia (CAP). Several studies have used PCR to establish the importance of viruses in the aetiology of CAP.We performed a systematic review and meta-analysis of the studies that reported the proportion of viral infection detected via PCR in patients with CAP. We excluded studies with paediatric populations. The primary outcome was the proportion of patients with viral infection. The secondary outcome was short-term mortality.Our review included 31 studies. Most obtained PCR via nasopharyngeal or oropharyngeal swab. The pooled proportion of patients with viral infection was 24.5% (95% CI 21.5-27.5%). In studies that obtained lower respiratory samples in >50% of patients, the proportion was 44.2% (95% CI 35.1-53.3%). The odds of death were higher in patients with dual bacterial and viral infection (OR 2.1, 95% CI 1.32-3.31).Viral infection is present in a high proportion of patients with CAP. The true proportion of viral infection is probably underestimated because of negative test results from nasopharyngeal or oropharyngeal swab PCR. There is increased mortality in patients with dual bacterial and viral infection. @ERSpublications Viral infection is present in a high proportion of patients with community-acquired pneumonia

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Section: Discussionmentioning

confidence: 76%

Section: Individual Virusesmentioning

confidence: 99%

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Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

et al. 2016

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“…Además, las muestras congeladas y descongeladas pueden reducir la sensibilidad de la PCR. Coincidentemente, en el mismo estudio de Templeton, aquellos casos sin diagnóstico eran un grupo oligosintomático, lo que pudiera estar asociado a menor carga viral y menor rendimiento de test diagnósticos 10 . Esto se asemeja a nuestros pacientes con RT-PCR (-) ya que en ellos se identifi caron algunos elementos que sugieren formas más leves: hospitalización más breve, ausencia de SDRA, menor requerimiento de UCI y VM.…”

Section: Discussionunclassified

Impacto clínico de la influenza A H1N1 pandémica en el hospital de Puerto Montt, Chile

et al. 2011

Rev. méd. Chile

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“…Rapid diagnostic methods help to avoid inadequate antimicrobial treatment and support infection control interventions to limit nosocomial infections . Molecular methods demonstrate greater sensitivity than conventional assays for detecting adenovirus in respiratory samples 11,12 . Brazilian studies have described HAdV frequencies of 3 to 7.1%, as measured using different diagnostic techniques [13][14][15][16] .…”

Section: Human Adenovirus Detection Among Immunocompetent and Immunocmentioning

confidence: 99%

Human adenovirus detection among immunocompetent and immunocompromised patients presenting acute respiratory infection

Watanabe

Carraro²,

Camargo

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction: Human adenoviruses (HAdV) play an important role in the aetiology of severe acute lower respiratory infection, especially in immunocompromised individuals. The aim of the present study was to detect HAdV using two different methods, direct fluorescence assay (DFA) and nested polymerase chain reaction (nested PCR), in samples collected from patients with acute respiratory infection (ARI) within 7 days of symptom onset. Methods: Samples (n=643) were collected from patients in different risk groups from 2001 to 2010: 139 adult emergency room patients (ERP); 205 health care workers (HCW); 69 renal transplant outpatients (RTO); and 230 patients in a haematopoietic stem cell transplantation program (HSCT). Results: Adenovirus was detected in 13.2% of the 643 patients tested by DFA and/or PCR: 6/139 (4.3%) adults in the ERP group, 7/205 (3.4%) in the HCW group, 4/69 (5.8%) in the RTO group and 68/230 (29.5%) in the HSCT patient group. Nested PCR had a higher detection rate (10%) compared with the DFA test (3.8%) (p<0.001). HSCT patients exhibited a significantly higher rate of HAdV infection. Conclusions: The adenovirus detection rate of the nested PCR assay was higher than that of the DFA test. However, the use of molecular methods in routine diagnostic laboratory work should be evaluated based on the specific circumstances of individual health services.

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Improved Diagnosis of the Etiology of Community-Acquired Pneumonia with Real-Time Polymerase Chain Reaction

Abstract: The combined real-time PCR assay is more sensitive for diagnosis of the main viruses and atypical bacteria that cause CAP compared with conventional methods, and obtains results in a clinically relevant time period.

Cited by 292 publications

References 42 publications

Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

Impacto clínico de la influenza A H1N1 pandémica en el hospital de Puerto Montt, Chile

Human adenovirus detection among immunocompetent and immunocompromised patients presenting acute respiratory infection

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