title: Pleural fluid PCR method for detection of Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae in pediatric parapneumonic effusions.
abstract: BACKGROUND
  Parapneumonic effusions cause significant morbidity and mortality despite current developments in diagnostic and therapeutic approaches. Causative microorganisms may remain unidentified in a significant number of patients by cultures and Gram smears. Polymerase chain reaction (PCR) is a molecular technique for the detection of causative bacteria; however, its efficiency in pleural fluids is less known.
  
  
  OBJECTIVE
  The present study was performed to compare the efficiency of PCR in the detection of the three most common organisms (Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae) with conventional methods.
  
  
  METHODS
  Twenty-eight consecutive patients with parapneumonic pleural effusions were studied. On admission, pleural fluid samples were obtained for Gram staining, routine culture and PCR analysis for S. aureus, S. pneumoniae and H. influenzae.
  
  
  RESULTS
  PCR analysis allowed detection of 11 microorganisms in 10 patients (35.7%), whereas pleural fluid cultures detected the etiological agent in only 2 (7.1%). S. pneumoniae was the most frequent agent.
  
  
  CONCLUSIONS
  Pleural fluid cultures may have low diagnostic yields, partly due to prior antibiotic use. Pleural fluid PCR analysis may improve the etiologic diagnosis in parapneumonic pleural effusions, with technical advances leading to higher yields than obtained in this study.
authors.affiliation: Department of Pediatrics, Division of Chest Diseases, Hacettepe University, Faculty of Medicine, Sihhiye/Ankara, Turkey. geutine@hacettepe.edu.tr
authors.forename: G Eda
authors.initials: GE
authors.lastname: Utine
authors.forename: Ahmet
authors.initials: A
authors.lastname: Pinar
authors.forename: Uğur
authors.initials: U
authors.lastname: Ozçelik
authors.forename: Burçin
authors.initials: B
authors.lastname: Sener
authors.forename: Ebru
authors.initials: E
authors.lastname: Yalçin
authors.forename: Deniz
authors.initials: D
authors.lastname: Doğru
authors.forename: Dilek
authors.initials: D
authors.lastname: Menemenlioğlu
authors.forename: Deniz
authors.initials: D
authors.lastname: Gür
authors.forename: Nural
authors.initials: N
authors.lastname: Kiper
authors.forename: Ayhan
authors.initials: A
authors.lastname: Göçmen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D010996:Pleural Effusion / Q000209:etiology / Q000382:microbiology*; D018410:Pneumonia, Bacterial / Q000150:complications / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*