Pneumococcal Colonisation Rates in Patients Admitted to a UK Hospital with Lower Respiratory Tract Infection - a prospective case-control study

Autor: Collins, Andrea, Johnstone, Catherine M K, Gritzfeld, Jenna, Banyard, Antonia, Hancock, Carole, Wright, Angela, Macfarlane, Laura, Ferreira, Daniela, Gordon, Stephen
Jazyk: angličtina
Rok vydání: 2016
Předmět:
ISSN: 1098-660x
Popis: BACKGROUND\ud Current diagnostic tests are ineffective at identifying the aetiological pathogen in hospitalised adults with lower respiratory tract infection (LRTI). The association of pneumococcal colonisation with disease has been suggested as a means to increase diagnostic precision. We compared pneumococcal colonisation rate and density of nasal pneumococcal colonisation by a) classical culture and b) quantitative real time lytA Polymerase Chain Reaction (qPCR) in patients admitted to hospital in the UK with LRTI compared to control patients.\ud \ud METHODS\ud 826 patients were screened for inclusion in this prospective case-control study. 38 patients were recruited, 19 with confirmed LRTI and 19 controls with another diagnosis. Nasal wash (NW) was collected at the time of recruitment.\ud \ud RESULTS\ud Pneumococcal colonisation was detected in 1 LRTI patient and 3 controls (p=0.6) by classical culture. Using qPCR pneumococcal colonisation was detected in 10 LRTI patients and 8 controls (p=0.5). Antibiotic usage prior to sampling was significantly higher in the LRTI than control group 19 v. 3 (p8000 copies/ml on qPCR pneumococcal colonisation was found in 3 LRTI patients and 4 controls (p > 0.05).\ud \ud CONCLUSIONS\ud We conclude that neither prevalence nor density of nasal pneumococcal colonisation (by culture and qPCR) can be used as a method of microbiological diagnosis in hospitalised adults with LRTI in the UK. A community based study recruiting patients prior to antibiotic therapy may be a useful future step.
Databáze: OpenAIRE