Pleural effusion with negative culture: a challenge for pneumococcal diagnosis in children
| Autor: | Vinicius Pieta Perez, Juliana Caierão, Cícero Armídio Gomes Dias, Gilberto Bueno Fischer, Pedro Alves d'Azevedo |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) Adolescent Pleural effusion 030106 microbiology Real-Time Polymerase Chain Reaction medicine.disease_cause Chromatography Affinity Pneumococcal Infections Parapneumonic effusion 03 medical and health sciences 0302 clinical medicine Antigen Streptococcus pneumoniae Humans Medicine Prospective Studies 030212 general & internal medicine Antibiotic use Child Bacteriological Techniques business.industry Infant General Medicine medicine.disease Empyema Pleural Effusion Pneumococcal infections Infectious Diseases Real-time polymerase chain reaction Child Preschool Immunology Female business |
| Zdroj: | Diagnostic Microbiology and Infectious Disease. 86:200-204 |
| ISSN: | 0732-8893 |
| DOI: | 10.1016/j.diagmicrobio.2016.07.022 |
| Popis: | Background Pneumococcal parapneumonic effusion seems to be increasing in children in the postvaccine era and is frequently associated with negative culture. Due to the low yield of culture, culture-independent tools are evaluated. Methods Culture-negative pleural fluid specimens from 38 children with parapneumonic effusion were examined for pneumococcal lytA by quantitative polymerase chain reaction (qPCR) and soluble antigen (C-polysaccharide) using an immunochromatographic test (BinaxNow Streptococcus pneumoniae ). Results In 81% (30/37) and 63% (24/38) of the specimens, a positive result was obtained by qPCR and antigen detection, respectively. Most mismatches were observed in specimens with low quantities of pneumococcal DNA and a negative antigen test. Conclusions Our results suggest an imperfect relationship between the 2 described methods. The immunochromatographic assay is a simple diagnostic tool, which can be used when resources are limited, and even after antibiotic use, but negative results may require confirmation through a more sensitive test, such as qPCR. |
| Databáze: | OpenAIRE |
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