title: Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR.
abstract: Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI). Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections. The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI. During 2001, 65 children were prospectively studied. Microbiological investigation consisted of capillary PCR with a LightCycler for M. pneumoniae and L. pneumophila in induced sputum or throat swab specimens, IgM enzyme immunoassay for M. pneumoniae and immunofluorescence for L. pneumophila in paired sera. Serology testing showed acute M. pneumoniae infection in 18 (27.5%) patients and L. pneumophila in 1 (1.5%). M. pneumoniae was also detected in sputum specimen by capillary PCR in 9 (50%) serologically diagnosed cases, including 4 (22%) with non-diagnostic IgM levels in the acute phase. Capillary PCR and IgM enzyme immunoassay diagnosed together 15 (83%) M. pneumoniae cases in the acute phase. It is concluded that M. pneumoniae is an important cause of LRTI necessitating hospitalization among children in Greece. Capillary PCR in sputum may diagnose M. pneumoniae LRTI in the acute setting and direct therapy and isolation of patients.
authors.affiliation: University of Athens Second Department of Paediatrics, P. & A. Kyriakou Children's Hospital, Athens 11527, Greece. helen-maltezou@ath.forthnet.gr
authors.forename: Helen C
authors.initials: HC
authors.lastname: Maltezou
authors.forename: Bernard
authors.initials: B
authors.lastname: La-Scola
authors.forename: Helen
authors.initials: H
authors.lastname: Astra
authors.forename: Ioanna
authors.initials: I
authors.lastname: Constantopoulou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Vlahou
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Kafetzis
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Constantopoulos
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001483:Base Sequence; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000382:microbiology; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D016952:Legionella pneumophila / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008969:Molecular Sequence Data; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D017678:Sex Distribution