title: [Comparison of culture and real-time PCR methods in the detection of Streptococcus pneumoniae and Haemophilus influenzae in acute otitis media effusion specimens].
abstract: Streptococcus pneumoniae and Haemophilus influenzae are the major etiologic agents of acute otitis media. This study was aimed to compare the detection rate of S.pneumoniae and H.influenzae by culture and real-time polymerase chain reaction (Rt-PCR) in the middle ear effusions of patients diagnosed as acute otitis media. A total of 60 middle ear effusion samples collected from children with acute otitis media were included in the study. The samples were inoculated and incubated in BACTEC Ped Plus blood culture bottles and BACTEC 9120 system (BD Diagnostic Systems, MD), respectively, and the isolates were identified by conventional methods. For the molecular diagnosis of H.influenzae and S.pneumoniae, ply pneumolysin gene and HIB capsule region, respectively were amplified by Rt-PCR (LightCycler, Roche Diagnostics, Germany). H.influenzae and S.pneumoniae were isolated from 5 (8.3%) and 3 (5%) of the patient samples with conventional culture methods, respectively. In addition in 11.6% of the samples other microorganisms (Staphylococcus epidermidis, Streptococcus intermedius, Streptococcus sanguinis, Moraxella catarrhalis, Pseudomonas aeruginosa, Candida albicans) were also isolated. On the other hand H.influenzae and S.pneumoniae were detected in 38 (63.3%) and 24 (40%) of the samples with Rt-PCR,  respectively. There was about eight fold increase in the detection frequency of H.influenzae and S.pneumoniae with Rt-PCR compared to culture methods. When culture was accepted as the gold standard method, the sensitivity, specificity and positive predictive value of Rt-PCR in the detection of H.influenzae and S.pneumoniae were estimated as 80%, 51% and 98.2%, respectively. As a result, Rt-PCR was shown to be a sensitive method and could be preferred for the rapid diagnosis of H.influenzae and S.pneumoniae in the etiological diagnosis of acute otitis media, especially in culture negative cases.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey. ozgen.eser@hacettepe.edu.tr
authors.forename: Ozgen Köseoğlu
authors.initials: OK
authors.lastname: Eser
authors.forename: Sehnaz
authors.initials: S
authors.lastname: Alp
authors.forename: Alper
authors.initials: A
authors.lastname: Ergin
authors.forename: Kaan
authors.initials: K
authors.lastname: Ipçi
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Alp
authors.forename: Deniz
authors.initials: D
authors.lastname: Gür
authors.forename: Gülşen
authors.initials: G
authors.lastname: Hasçelik
mesh_terms: D000208:Acute Disease; D016667:Bacterial Capsules / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D006192:Haemophilus Infections / Q000175:diagnosis / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction / Q000592:standards*; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D013301:Streptolysins / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D013301:Streptolysins; C032290:plY protein, Streptococcus pneumoniae