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Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia

Community‐acquired pneumonia (CAP) is a serious clinical concern. A lack of accurate diagnosis could hinder pathogen‐directed therapeutic strategies. To solve this problem, we evaluated clinical application of nested multiplex polymerase chain reaction (PCR) in children with severe CAP. We prospecti...

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Autores principales: Yen, Ting‐Yu, Chen, Jian‐Fu, Lu, Chun‐Yi, Wu, En‐Ting, Wang, Ching‐Chia, Lu, Frank Leigh, Huang, Li‐Min, Chang, Luan‐Yin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10108056/
https://www.ncbi.nlm.nih.gov/pubmed/36418155
http://dx.doi.org/10.1002/jmv.28334
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author Yen, Ting‐Yu
Chen, Jian‐Fu
Lu, Chun‐Yi
Wu, En‐Ting
Wang, Ching‐Chia
Lu, Frank Leigh
Huang, Li‐Min
Chang, Luan‐Yin
author_facet Yen, Ting‐Yu
Chen, Jian‐Fu
Lu, Chun‐Yi
Wu, En‐Ting
Wang, Ching‐Chia
Lu, Frank Leigh
Huang, Li‐Min
Chang, Luan‐Yin
author_sort Yen, Ting‐Yu
collection PubMed
description Community‐acquired pneumonia (CAP) is a serious clinical concern. A lack of accurate diagnosis could hinder pathogen‐directed therapeutic strategies. To solve this problem, we evaluated clinical application of nested multiplex polymerase chain reaction (PCR) in children with severe CAP. We prospectively enrolled 60 children with severe CAP requiring intensive care between December 2019 and November 2021 at a tertiary medical center. Nested multiplex PCR respiratory panel (RP) and pneumonia panel (PP) were performed on upper and lower respiratory tract specimens. We integrated standard‐of‐care tests and quantitative PCR for validation. The combination of RP, PP, and standard‐of‐care tests could detect at least one pathogen in 98% of cases and the mixed viral‐bacterial detection rate was 65%. The positive percent agreement (PPA), and negative percent agreement (NPA) for RP were 94% and 99%; the PPA and NPA for PP were 89% and 98%. The distribution of pathogens was similar in the upper and lower respiratory tracts, and the DNA or RNA copies of pathogens in the lower respiratory tract were equal to or higher than those in the upper respiratory tract. PP detected bacterial pathogens in 40 (67%) cases, and clinicians tended to increase bacterial diagnosis and escalate antimicrobial therapy for them. RP and PP had satisfactory performance to help pediatricians make pathogenic diagnoses and establish therapy earlier. The pathogens in the upper respiratory tract had predictive diagnostic values for lower respiratory tract infections in children with severe CAP.
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spelling pubmed-101080562023-04-18 Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia Yen, Ting‐Yu Chen, Jian‐Fu Lu, Chun‐Yi Wu, En‐Ting Wang, Ching‐Chia Lu, Frank Leigh Huang, Li‐Min Chang, Luan‐Yin J Med Virol Research Articles Community‐acquired pneumonia (CAP) is a serious clinical concern. A lack of accurate diagnosis could hinder pathogen‐directed therapeutic strategies. To solve this problem, we evaluated clinical application of nested multiplex polymerase chain reaction (PCR) in children with severe CAP. We prospectively enrolled 60 children with severe CAP requiring intensive care between December 2019 and November 2021 at a tertiary medical center. Nested multiplex PCR respiratory panel (RP) and pneumonia panel (PP) were performed on upper and lower respiratory tract specimens. We integrated standard‐of‐care tests and quantitative PCR for validation. The combination of RP, PP, and standard‐of‐care tests could detect at least one pathogen in 98% of cases and the mixed viral‐bacterial detection rate was 65%. The positive percent agreement (PPA), and negative percent agreement (NPA) for RP were 94% and 99%; the PPA and NPA for PP were 89% and 98%. The distribution of pathogens was similar in the upper and lower respiratory tracts, and the DNA or RNA copies of pathogens in the lower respiratory tract were equal to or higher than those in the upper respiratory tract. PP detected bacterial pathogens in 40 (67%) cases, and clinicians tended to increase bacterial diagnosis and escalate antimicrobial therapy for them. RP and PP had satisfactory performance to help pediatricians make pathogenic diagnoses and establish therapy earlier. The pathogens in the upper respiratory tract had predictive diagnostic values for lower respiratory tract infections in children with severe CAP. John Wiley and Sons Inc. 2022-12-02 2023-01 /pmc/articles/PMC10108056/ /pubmed/36418155 http://dx.doi.org/10.1002/jmv.28334 Text en © 2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Yen, Ting‐Yu
Chen, Jian‐Fu
Lu, Chun‐Yi
Wu, En‐Ting
Wang, Ching‐Chia
Lu, Frank Leigh
Huang, Li‐Min
Chang, Luan‐Yin
Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title_full Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title_fullStr Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title_full_unstemmed Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title_short Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
title_sort application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community‐acquired pneumonia
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10108056/
https://www.ncbi.nlm.nih.gov/pubmed/36418155
http://dx.doi.org/10.1002/jmv.28334
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