The Effect of Antibiotic Exposure and Specimen Volume on the Detection of Bacterial Pathogens in Children With Pneumonia
| Autor: | Christine Prosperi, Daniel R. Feikin, Caroline W. Gitahi, Shabir A. Madhi, Dilruba Ahmed, Jessica McLellan, Muhammad Saifullah, Amanda J. Driscoll, David P. Moore, Phil Seidenberg, Ruth A. Karron, Orin S. Levine, Brooks Wa, Melissa M. Higdon, Boubou Tamboura, Deloria Knoll M, Peter V. Adrian, Henry C. Baggett, David R. Murdoch, Karen L. Kotloff, Razib Mazumder, Howie Src, Donald M. Thea, Bernard E. Ebruke, Samba O. Sow, Katherine L O'Brien, Anek Kaewpan, Julia Rhodes, Daniel E. Park, Lawrence Mwananyanda, Laura L. Hammitt, Scott Jag., Angela Karani, Andrea DeLuca, Scott L. Zeger |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Internationality Antibiotics Oropharynx medicine.disease_cause blood culture law.invention 0302 clinical medicine law Nasopharynx Medicine Bioassay Blood culture 030212 general & internal medicine Polymerase chain reaction medicine.diagnostic_test biology 3. Good health Anti-Bacterial Agents Infectious Diseases Streptococcus pneumoniae Specimen collection Molecular Diagnostic Techniques Child Preschool Female Supplement Article Microbiology (medical) medicine.drug_class 030106 microbiology Real-Time Polymerase Chain Reaction Microbiology 03 medical and health sciences Pneumonia Bacterial Humans pneumonia Bacteriological Techniques Bacteria business.industry Infant Newborn Sputum Infant biology.organism_classification medicine.disease Pneumonia children antibiotic exposure Case-Control Studies Immunology business |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| Popis: | Background Antibiotic exposure and specimen volume are known to affect pathogen detection by culture. Here we assess their effects on bacterial pathogen detection by both culture and polymerase chain reaction (PCR) in children. Methods PERCH (Pneumonia Etiology Research for Child Health) is a case-control study of pneumonia in children aged 1–59 months investigating pathogens in blood, nasopharyngeal/oropharyngeal (NP/OP) swabs, and induced sputum by culture and PCR. Antibiotic exposure was ascertained by serum bioassay, and for cases, by a record of antibiotic treatment prior to specimen collection. Inoculated blood culture bottles were weighed to estimate volume. Results Antibiotic exposure ranged by specimen type from 43.5% to 81.7% in 4223 cases and was detected in 2.3% of 4863 controls. Antibiotics were associated with a 45% reduction in blood culture yield and approximately 20% reduction in yield from induced sputum culture. Reduction in yield of Streptococcus pneumoniae from NP culture was approximately 30% in cases and approximately 32% in controls. Several bacteria had significant but marginal reductions (by 5%–7%) in detection by PCR in NP/ OP swabs from both cases and controls, with the exception of S. pneumoniae in exposed controls, which was detected 25% less frequently compared to nonexposed controls. Bacterial detection in induced sputum by PCR decreased 7% for exposed compared to nonexposed cases. For every additional 1 mL of blood culture specimen collected, microbial yield increased 0.51% (95% confidence interval, 0.47%–0.54%), from 2% when volume was ≤1 mL to approximately 6% for ≥3 mL. Conclusions Antibiotic exposure and blood culture volume affect detection of bacterial pathogens in children with pneumonia and should be accounted for in studies of etiology and in clinical management. |
| Databáze: | OpenAIRE |
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