Microbiological Diagnosis of Empyema in Children: Comparative Evaluations by Culture, Polymerase Chain Reaction, and Pneumococcal Antigen Detection in Pleural Fluids

Monnier, Alban Le; Carbonnelle, Étienne; Zahar, Jean‐Ralph; Bourgeois, M. Le; Abachin, Éric; Quesne, Gilles; Varon, Emmanuelle; Descamps, Philippe; Blic, J. de; Scheinmann, P.; Berche, Patrick; Ferroni, Agnès

doi:10.1086/502680

Cited by 150 publications

(129 citation statements)

References 28 publications

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“…21 In addition, nucleic acid amplification through polymerase chain reaction (PCR) and antigen testing are indispensable tools in the detection of microorganisms in cases with PPE. 17,22 In a study conducted in Spain, pneumococci were detected in 79% of culture-positive and 84% of culture-negative samples using real-time PCR; almost 50% were serotype 1. 4 Le Monnier et al 17 found that the sensitivity and specificity of the latex antigen detection in PPE were 90% and 95%, respectively.…”

Section: Microbiologymentioning

confidence: 99%

Parapneumonic Effusion in Children

Hendaus

Janahi

2015

Clin Pediatr (Phila)

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Section: Microbiologymentioning

confidence: 99%

Parapneumonic Effusion in Children

Hendaus

Janahi

2015

Clin Pediatr (Phila)

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“…23 However, microbiological cultures may produce false negatives for several reasons: small sample volume, slow growing bacteria, uncommon phenotypes, previous antibiotic therapy or inadequate conditions of transport and storage. 16,24 The main purpose of obtaining intraoperative samples for microbiological cultures in appendicitis was to identify, whether pathogens resistant to empirical antibiotics were present. Foo and colleagues collected data from more than 600 cases of acute appendicitis, demonstrating that less than 20 cultures grew resistant pathogens.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18][19] In pleural empyema, RT-PCR played an important role identifying pathogens in those patients with no culture growth, who had followed a previous antibiotic course. 15,16 Similar results were available for microbiological diagnosis in spontaneous bacterial peritonitis where RT-PCR increased the efficacy of cultures: RT-PCR detected pathogen in nearly all the patients with positive culture, and RT-PCR resulted positive in half of the patients with negative cultures. 17 Although molecular diagnosis cannot be considered as a replacement method in the clinical setting, there is an increasing awareness of the benefits, which may derive from the combined use of molecular analyses and conventional microbiology to optimize the research of pathogens.…”

Section: Articlementioning

confidence: 99%

“…17 Although molecular diagnosis cannot be considered as a replacement method in the clinical setting, there is an increasing awareness of the benefits, which may derive from the combined use of molecular analyses and conventional microbiology to optimize the research of pathogens. 16,24,25 Concerning our pilot study, RT-PCR has been undoubtedly a valuable tool to detect aggressive pathogens such as anaerobia, which are usually difficult to preserve alive in biological cultures. Almost all the operations in this series were performed by means of laparoscopy, a procedure that requires intraabdominal insufflation of carbon dioxide.…”

Section: Articlementioning

confidence: 99%

“…14 RT-PCR has been employed in several studies with pediatric populations confirming that a prompt detection of either viral or bacterial agent contributes to patient care, which in turn has effect on both hospital stay and antibiotic usage. [15][16][17][18][19] To date, a couple of studies about the use of RT-PCR to detect pathogens in the peritoneal fluid during acute appendicitis have been carried out without any further conclusion. 20,21 Taking into account these previous reports, we set a pilot study in order to better understand and compare the potential advantages of DNA amplification versus traditional bacterial growth culture in complicated acute appendicitis, and identify, when possible, those categories of patients, who might benefit from this combined approach.…”

Section: Introductionmentioning

confidence: 99%

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The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

et al. 2016

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Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases), Pseudomonas aeruginosa (3), Fusobacterium necrophorum (3), Adenovirus (2), E.coli (1), Klebsiella pneumoniae (1), Serratia marcescens/Enterobacter cloacae (1). Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.

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Broad‐range bacterial polymerase chain reaction in the microbiologic diagnosis of complicated pneumonia

Gollomp

Rankin

White

et al. 2011

Journal of Hospital Medicine

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BACKGROUND: A bacterial cause is not frequently identified in children with pneumonia complicated by parapneumonic effusion (ie, complicated pneumonia). OBJECTIVES: To determine the frequency of positive blood and pleural fluid cultures in children with complicated pneumonia and to determine whether broad‐range 16S rRNA polymerase chain reaction (PCR) improves identification of a microbiologic cause. METHODS: This prospective cohort study included children 1–18 years of age hospitalized with complicated pneumonia. RESULTS: Pleural fluid drainage was performed in 64 (51.6%) of 124 children with complicated pneumonia. A microbiologic cause was identified in 11 of 64 patients (17.2%; 95% confidence interval [CI]: 8.9%–28.7%). Bacteria were isolated from pleural fluid culture in 6 of 64 patients (9.4 %; 95% CI: 3.5%–19.3%) undergoing pleural drainage; the causative bacteria were Staphylococcus aureus (n = 5) and Streptococcus pneumoniae (n = 1). Blood culture identified a bacterial cause in 3 of 44 cases (6.8%; 95% CI: 1.4%–18.7%) undergoing pleural fluid drainage; S. pneumoniae (n = 1), Haemophilus influenzae (n = 1), and S. aureus (n = 1) were isolated. Only 3 of the 19 pleural fluid samples (15.8%; 95% CI: 3.4%–39.6%) analyzed with 16S rRNA PCR were positive. S. pneumoniae was the only organism detected in all three samples; two of these three had negative pleural fluid cultures and absence of bacteria on Gram stain. S. aureus was isolated from pleural fluid culture in one patient with a negative 16S rRNA PCR test. CONCLUSIONS: Causative bacteria were infrequently identified in children with complicated pneumonia. Broad‐range 16S rRNA PCR only modestly improved the microbiologic yield over conventional culture methods. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine

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Microbiological Diagnosis of Empyema in Children: Comparative Evaluations by Culture, Polymerase Chain Reaction, and Pneumococcal Antigen Detection in Pleural Fluids

Cited by 150 publications

References 28 publications

Parapneumonic Effusion in Children

Parapneumonic Effusion in Children

The Role of DNA Amplification and Cultural Growth in Complicated Acute Appendicitis

Broad‐range bacterial polymerase chain reaction in the microbiologic diagnosis of complicated pneumonia

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