What to expect from molecular tools for non-documented pediatric infectious diseases.
OBJECTIVE
Evaluation of the contribution of molecular tools to the overall diagnosis of infectious diseases in children.


METHODS
Results of 16S rDNA analysis (179 children; 228 specimens), combined to specific amplification of Kingella kingae (126 children; 166 osteoarticular specimens), were retrospectively analyzed for samples with inconclusive cultures.


RESULTS
The overall positive yield in diagnosis was 12.8% of the patients for 16S rDNA PCR, 40.5% for K. kingae PCR and 45.2% for combined use of both methods. Results were related to clinical and biological data (direct examination, certainty/uncertainty of clinical diagnosis, fever, biological markers, previous antibiotics), and to the number of samples analyzed per patient, allowing the identification of specific situations with significant contribution of PCR methods.


CONCLUSIONS
Molecular techniques constitute valuable tools to improve the bacterial infection diagnosis in children; however, specific indications, dedicated samples, and number of analyzed samples per patient are key points to optimize their contribution.
a Service de Pédiatrie, Hôpital Carémeau , Centre Hospitalier Universitaire de Nîmes , Nîmes cedex 9 , France.|b INSERM U 1183, Equipe 3, Groupe nîmois, Immuno-régulation et microbiote, Faculté de médecine Montpellier Nîmes, Nîmes Cedex 2 , France.
Anne
A
Filleron
c UMR HydroSciences Montpellier, Equipe Pathogènes Hydriques Santé Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques , Université Montpellier 1 , Montpellier Cedex 5 , France.|d Laboratoire de Bactériologie, Hôpital Arnaud de Villeneuve , Centre Hospitalier Régional Universitaire de Montpellier , Montpellier Cedex 5 , France.
Anne-Laure
AL
Michon
c UMR HydroSciences Montpellier, Equipe Pathogènes Hydriques Santé Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques , Université Montpellier 1 , Montpellier Cedex 5 , France.|e Laboratoire d'Hygiène hospitalière, Hôpital Saint-Eloi , Centre Hospitalier Régional Universitaire de Montpellier , Montpellier Cedex 5, France.
Estelle
E
Jumas-Bilak
f Département de Pédiatrie, Hôpital Arnaud de Villeneuve , Centre Hospitalier Régional Universitaire de Montpellier , Montpellier Cedex 5 , France.
Eric
E
Jeziorski
c UMR HydroSciences Montpellier, Equipe Pathogènes Hydriques Santé Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques , Université Montpellier 1 , Montpellier Cedex 5 , France.
Isabelle
I
Zorgniotti
a Service de Pédiatrie, Hôpital Carémeau , Centre Hospitalier Universitaire de Nîmes , Nîmes cedex 9 , France.|b INSERM U 1183, Equipe 3, Groupe nîmois, Immuno-régulation et microbiote, Faculté de médecine Montpellier Nîmes, Nîmes Cedex 2 , France.
Tu Anh
TA
Tran
g IUCT Oncopole , Institut Claudius Regaud , Toulouse Cedex 9 , France.
Thomas
T
Filleron
f Département de Pédiatrie, Hôpital Arnaud de Villeneuve , Centre Hospitalier Régional Universitaire de Montpellier , Montpellier Cedex 5 , France.
Michel
M
Rodière
c UMR HydroSciences Montpellier, Equipe Pathogènes Hydriques Santé Environnements, U.F.R. des Sciences Pharmaceutiques et Biologiques , Université Montpellier 1 , Montpellier Cedex 5 , France.|d Laboratoire de Bactériologie, Hôpital Arnaud de Villeneuve , Centre Hospitalier Régional Universitaire de Montpellier , Montpellier Cedex 5 , France.
Hélène
H
Marchandin
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017882:Kingella kingae / Q000235:genetics; D008297:Male; D025202:Molecular Diagnostic Techniques; D016870:Neisseriaceae Infections / Q000175:diagnosis / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D012336:RNA, Ribosomal, 16S
16S rRNA gene; DNA sequencing; Kingella kingae; PCR; children; infectious diseases