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A practical approach estimating etiologic agents using real-time PCR in pediatric inpatients with community-acquired pneumonia

  • Original Article
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Journal of Infection and Chemotherapy

Abstract

To evaluate pathogens in pediatric inpatients with community-acquired pneumonia (CAP), an Acute Respiratory Diseases Study Group organized by ten Japanese medical institutions devised a rapid, reliable process based on real-time PCR results in nasopharyngeal swab samples plus admission blood test results. From April 2008 to April 2009, we enrolled 903 children with CAP based on chest radiographs and clinical findings who were hospitalized within 5 days of onset. Comprehensive real-time PCR was used to detect 6 bacteria and 11 respiratory viruses. The swab specimens also were used for bacterial cultures. After initial determination of presence or absence of viral and mycoplasmal infections, significant bacterial contributions were defined by bacterial identification, clinical efficacy of antimicrobial agent, and reference to blood test results. Children were stratified by age: below 1 year, 1 year, 2–5 years, or at least 6 years old. Among patients studied, 34.4 % were diagnosed with viral infection; 21.8 %, bacterial infection; 17.5 %, viral/bacterial co-infection; 5.9 %, mycoplasmal infection; 0.3 %, mycoplasmal/bacterial co-infection; and 1.7 %, viral/mycoplasmal co-infection. The remaining 18.4 % had unknown pathogens. Purely viral infection was suggested mainly in infants younger than 1 year; mycoplasmal infection typically occurred in children at least 6 years old. Our results suggest usefulness of real-time PCR for nasopharyngeal samples together with blood tests in estimating etiologic agents in clinical settings.

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Authors and Affiliations

  1. Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan

    Takafumi Okada, Keita Matsubara & Satoshi Iwata

  2. Laboratory of Molecular Epidemiology for Infectious Agents, Kitasato Institute for Life Sciences, Tokyo, Japan

    Takafumi Okada, Miyuki Morozumi, Naoko Chiba & Kimiko Ubukata

  3. Department of Pediatrics, Asahikawa Kosei Hospital, Hokkaido, Japan

    Hiroshi Sakata

  4. Department of Pediatrics, Tohoku Rosai Hospital, Miyagi, Japan

    Reiko Takayanagi

  5. Department of Pediatrics, Chiba University Hospital, Chiba, Japan

    Naruhiko Ishiwada

  6. Department of Pediatrics, Health Insurance Society of General Ota Hospital, Fuji Heavy Industries Ltd., Gunma, Japan

    Yoshitake Sato

  7. Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan

    Tomohiro Oishi

  8. Department of Pediatrics, Hakujikai Memorial Hospital, Tokyo, Japan

    Takeshi Tajima

  9. Department of Pediatrics, Kobe City Medical Center General Hospital, Hyogo, Japan

    Tunekazu Haruta

  10. Department of Pediatrics, Osaka Rosai Hospital, Osaka, Japan

    Naohisa Kawamura

  11. Department of Pediatrics, Kawasaki Medical School, Okayama, Japan

    Kazunobu Ouchi

  12. Laboratory of Infectious Diseases, Kitasato Institute for Life Sciences, Tokyo, Japan

    Takashi Takahashi

  13. Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan

    Satoshi Iwata

Authors
  1. Takafumi Okada
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  2. Miyuki Morozumi
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  3. Hiroshi Sakata
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  4. Reiko Takayanagi
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  7. Tomohiro Oishi
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  8. Takeshi Tajima
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  9. Tunekazu Haruta
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  12. Keita Matsubara
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  13. Naoko Chiba
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  14. Takashi Takahashi
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  15. Satoshi Iwata
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  16. Kimiko Ubukata
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Corresponding author

Correspondence to Takafumi Okada.

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Okada, T., Morozumi, M., Sakata, H. et al. A practical approach estimating etiologic agents using real-time PCR in pediatric inpatients with community-acquired pneumonia. J Infect Chemother 18, 832–840 (2012). https://doi.org/10.1007/s10156-012-0422-7

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  • DOI: https://doi.org/10.1007/s10156-012-0422-7

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