Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children.
OBJECTIVE
Most pleural effusions are associated with bacterial pneumonia, and the identification of the pathogen will assist the therapeutic decision. A specific method that is not affected by previous antibiotic therapy is sought to detect the main causative agents of pneumonia in infants and children (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus). The aim of the present study was to compare the polymerase chain reaction (PCR) technique with standard culture methods in identifying bacterial infections in infants' and children's pleural effusion.


METHODS
Samples obtained from pediatric patients (n = 37) with a diagnosis of pneumonia associated to pleural effusion, submitted to thoracentesis, were analyzed by PCR with specific primers.


RESULTS
The PCR technique identified the presence of bacterial infection in a larger proportion (95.2%) than the standard culture method (33.3%) on complicated pleural effusion samples. The microorganism detection on uncomplicated pleural effusion samples was positive only by the PCR method (31.3%). The frequencies of microorganisms identified on complicated pleural effusion were 57.1% of all patients for methicillin-resistant Staphylococcus; 52.4%, S pneumoniae; 28.6%, S aureus; and 23.8%, H influenzae. The previous use of antibiotics interferes with standard culture method, but it did not interfere with the PCR results.


CONCLUSIONS
The molecular diagnosis by PCR method could improve the etiologic diagnosis and might help to guide the treatment of parapneumonic effusion in children.
Menezes-Martins
Luis Felipe
LF
Surgery Department, Hospital São Lucas, Brazil.
Menezes-Martins
José João
JJ
Michaelsen
Vinicius S
VS
Aguiar
Bibiana B
BB
Ermel
Taisa
T
Machado
Denise C
DC
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D017931:DNA Primers; D004269:DNA, Bacterial / Q000235:genetics*; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000209:etiology* / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000235:genetics; D018410:Pneumonia, Bacterial / Q000150:complications* / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000235:genetics
D017931:DNA Primers; D004269:DNA, Bacterial