title: Improved Detection of Respiratory Pathogens by Use of High-Quality Sputum with TaqMan Array Card Technology.
abstract: New diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (<18 years old) and adults hospitalized with CAP were enrolled over 2.5 years through the Etiology of Pneumonia in the Community (EPIC) study. NP/OP specimens with matching high-quality sputum (defined as ≤10 epithelial cells/low-power field [lpf] and ≥25 white blood cells/lpf or a quality score [q-score] definition of 2+) were tested by TaqMan array card (TAC), a multipathogen real-time PCR detection platform. Among 236 patients with matched specimens, a higher proportion of sputum specimens had ≥1 pathogen detected compared with NP/OP specimens in children (93% versus 68%; P < 0.0001) and adults (88% versus 61%; P < 0.0001); for each pathogen targeted, crossing threshold (CT) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.
authors: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Bernard J
authors: 0000-0003-2768-5313
authors: BJ
authors: Wolff
authors: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Anna M
authors: AM
authors: Bramley
authors: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Kathleen A
authors: KA
authors: Thurman
authors: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Cynthia G
authors: CG
authors: Whitney
authors: Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Brett
authors: B
authors: Whitaker
authors: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors: Wesley H
authors: WH
authors: Self
authors: University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA.|Le Bonheur Children's Hospital, Memphis, Tennessee, USA.
authors: Sandra R
authors: SR
authors: Arnold
authors: University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA.
authors: Christopher
authors: C
authors: Trabue
authors: Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: Richard G
authors: RG
authors: Wunderink
authors: University of Tennessee Health Science Center/Saint Thomas Health, Nashville, Tennessee, USA.|Le Bonheur Children's Hospital, Memphis, Tennessee, USA.|St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors: Jon
authors: J
authors: McCullers
authors: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors: Kathryn M
authors: KM
authors: Edwards
authors: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Seema
authors: S
authors: Jain
authors: Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA jwinchell@cdc.gov.
authors: Jonas M
authors: JM
authors: Winchell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D010614:Pharynx / Q000382:microbiology* / Q000821:virology*; D011014:Pneumonia / Q000175:diagnosis*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D013183:Sputum / Q000382:microbiology* / Q000821:virology*; D055815:Young Adult
keywords: NP/OP; TAC; TaqMan array card; community-acquired pneumonia; diagnostics; multipathogen; pneumonia; sputum