| Autor: |
Park, Daniel E, Baggett, Henry C, Howie, Stephen RC, Shi, Qiyuan, Watson, Nora L, Brooks, W Abdullah, Deloria Knoll, Maria, Hammitt, Laura L, Kotloff, Karen L, Levine, Orin S, Madhi, Shabir A, Murdoch, David R, O'Brien, Katherine L, Scott, J Anthony G, Thea, Donald M, Ahmed, Dilruba, Antonio, Martin, Baillie, Vicky L, DeLuca, Andrea N, Driscoll, Amanda J, Fu, Wei, Gitahi, Caroline W, Olutunde, Emmanuel, Higdon, Melissa M, Hossain, Lokman, Karron, Ruth A, Maiga, Abdoul Aziz, Maloney, Susan A, Moore, David P, Morpeth, Susan C, Mwaba, John, Mwenechanya, Musaku, Prosperi, Christine, Sylla, Mamadou, Thamthitiwat, Somsak, Zeger, Scott L, Feikin, Daniel R, PERCH Study Group |
| Jazyk: |
angličtina |
| Rok vydání: |
2017 |
| ISSN: |
1058-4838 |
| Popis: |
BACKGROUND.: There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. METHODS.: In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR). Differences in median colonization density were evaluated using the Wilcoxon rank-sum test. Density cutoffs were determined using receiver operating characteristic curves. Cases with a pathogen identified from lung aspirate culture or PCR, pleural fluid culture or PCR, blood culture, and immunofluorescence for P. jirovecii defined microbiologically confirmed cases for the given pathogens. RESULTS.: Higher densities of H. influenzae were observed in both microbiologically confirmed cases and chest radiograph (CXR)-positive cases compared to controls. Staphylococcus aureus and P. jirovecii had higher densities in CXR-positive cases vs controls. A 5.9 log10 copies/mL density cutoff for H. influenzae yielded 86% sensitivity and 77% specificity for detecting microbiologically confirmed cases; however, densities overlapped between cases and controls and positive predictive values were poor ( |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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