title: Detection of bacteria and viruses in the pleural effusion of children and adults with community-acquired pneumonia.
abstract: OBJECTIVE
  To study the etiology and the utility of new molecular methods in the diagnosis of complicated pneumonia with empyema.
  
  
  METHODS
  Bacteria and viruses detection was performed by several traditional and molecular methods in the pleural fluid (PF) of 60 patients (38 children) with community-acquired pneumonia (CAP).
  
  
  RESULTS
  Despite prior antimicrobial therapy in 49 (81.7%) CAP patients, an etiological diagnosis could be established in 41 (68.3%), 35 being (58.3%) Streptococcus pneumoniae. PF culture was positive in only 6 patients but each molecular test detected more than 82% of cases.
  
  
  CONCLUSIONS
  Traditional culture methods have poor diagnostic sensitivity in PF because most CAP patients are under antimicrobial therapy when it is obtained. S. pneumoniae detection by molecular methods highly improves diagnosis.
authors.affiliation: Microbiology Department, Hospital Universitario Donostia-IIS-Biodonostia, San Sebastián, Spain.|Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Marimón
authors.affiliation: Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Morales
authors.affiliation: Microbiology Department, Hospital Universitario Donostia-IIS-Biodonostia, San Sebastián, Spain.|Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Cilla
authors.affiliation: Microbiology Department, Hospital Universitario Donostia-IIS-Biodonostia, San Sebastián, Spain.|Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Vicente
authors.affiliation: Microbiology Department, Hospital Universitario Donostia-IIS-Biodonostia, San Sebastián, Spain.|Biomedical Research Center Network for Respiratory Diseases (CIBERES), San Sebastián, Spain.|Faculty of Medicine, University of the Basque Country (UPV/EHU), San Sebastián, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Pérez-Trallero
mesh_terms: D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D006801:Humans; D008828:Microbiological Techniques / Q000379:methods; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D010996:Pleural Effusion / Q000382:microbiology* / Q000821:virology*; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D012680:Sensitivity and Specificity; D014780:Viruses / Q000302:isolation & purification*
keywords: Streptococcus pneumoniae; antigen-test BINAX-NOW; empyema; fast-track diagnostics multiplex PCR; lytA real-time PCR; pneumococcal-conjugated vaccine