Detection of respiratory viruses and Legionella spp. by real-time polymerase chain reaction in patients with community acquired pneumonia.
We conducted a study on throat swabs obtained from a group of hospitalized patients with community acquired pneumonia (CAP). Throat swab specimens from 242 adults admitted to hospital with CAP were tested. In total, 1 or more aetiological agents were identified by real-time PCR in 55 (23%) patients. The most frequently detected pathogens were coronavirus (17%), parainfluenza virus (6%) and influenza virus (4%). Overall, viral pathogens were identified by conventional techniques in 7 (2%) patients, and real-time PCR in 50 (21%) patients (p<0.0001). The diagnostic yield increased from 137 cases (57% of patients using conventional microbiological assays) to 158 cases (65% of patients using real-time PCR assays and conventional microbiological assays; p=0.06). A significantly higher percentage of mortality was present in patients with a mixed bacterial and viral infection. L. pneumophila PCR was positive in only 3 out of 11 cases (27%) of Legionnaires' disease (LD). This study demonstrates that real-time PCR can increase the number of microbiological detections of respiratory pathogens, mainly as a result of detection of respiratory viruses.
Diederen
Bram M W
BM
Regional Laboratory of Public Health Haarlem, Haarlem, Haarlem, The Netherlands. bramdiederen@gmail.com
Van Der Eerden
Menno M
MM
Vlaspolder
Fer
F
Boersma
Wim G
WG
Kluytmans
Jan A J W
JA
Peeters
Marcel F
MF
D000293:Adolescent; D000328:Adult; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000382:microbiology / Q000821:virology; D003470:Culture Media; D004269:DNA, Bacterial / Q000032:analysis / Q000302:isolation & purification; D004279:DNA, Viral / Q000032:analysis / Q000302:isolation & purification; D006760:Hospitalization; D006801:Humans; D007875:Legionella / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D016952:Legionella pneumophila / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology / Q000821:virology; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000382:microbiology; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods*; D014780:Viruses / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
D003470:Culture Media; D004269:DNA, Bacterial; D004279:DNA, Viral