重症肺炎和肺旁脓肿住院儿童的病毒和细菌病原体鉴定

IF 8.5 Q1 RESPIRATORY SYSTEM Pneumonia Pub Date : 2012-11-09 DOI:10.15172/pneu.2012.1/228
J. Telles, N. Richard, Y. Gillet, Susanne Hartwig, Stephane Pouzol, S. Dollet, M. Messaoudi, E. Paredes, C. Ploton, G. Lina, G. Vernet, D. Floret, E. Javouhey, G. Paranhos-Baccalà
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引用次数: 8

摘要

肺炎是由呼吸道细菌和/或病毒引起的。对于患有严重肺炎的住院儿童,合并感染是否是一个加重因素尚不清楚。我们研究了呼吸道病原体对肺炎严重程度的影响。在2007年至2009年期间,52名诊断为社区获得性肺炎(CAP)的住院儿童,伴有或不伴有肺旁脓肿(PPE),被纳入研究。将患者分为CAP + PPE组(n = 28)和CAP组(n = 24)。采用常规的细菌技术和分子检测方法对鼻咽吸出液和胸腔积液样本进行呼吸道病毒和细菌的鉴定。采用实时多重PCR和抗原检测,通过分子检测和BinaxNOW®胸膜液检测,76%的病例中发现肺炎链球菌是主要病原体。总共有8%的胸膜液样本未被诊断。在鼻咽吸入物中,CAP和CAP + PPE人群均检测到鼻病毒、副流感病毒、人偏肺病毒和呼吸道合胞病毒;然而,CAP + PPE患者鼻咽吸入物中病毒共检测的百分比(35%)明显高于CAP患者(5%)。总之,病毒共检主要见于重症肺炎患者。分子生物学检测提高了肺炎病原菌的检出率,证实了BinaxNOW®在胸腔积液标本中的肺炎链球菌检出率。有趣的是,PPE中发现的主要肺炎链球菌血清型并不是七价肺炎球菌结合疫苗所针对的血清型。
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Viral and bacterial pathogens identification in children hospitalised for severe pneumonia and parapneumonic empyema
Pneumonia is caused by respiratory bacteria and/or viruses. Little is known if co-infections are an aggravating factor in hospitalised children with severe pneumonia. We studied the impact of respiratory pathogens on the severity of pneumonia. Between 2007 and 2009, 52 children hospitalised with a well-documented diagnosis of community-acquired pneumonia (CAP), with or without parapneumonic empyema (PPE), were enrolled in the study. The patients were classified into 2 groups: CAP + PPE (n = 28) and CAP (n = 24). The identification of respiratory viruses and bacteria in nasopharyngeal aspirates and pleural effusion samples were performed using conventional bacterial techniques and molecular assays. Using real-time multiplex PCR and antigen detection, Streptococcus pneumoniae was the main agent identified in 76% of the cases by molecular tests and BinaxNOW® in pleural fluid. A total of 8% of pleural fluid samples remained undiagnosed. In nasopharyngeal aspirates, rhinovirus, parainfluenza viruses, human metapneumovirus, and respiratory syncytial virus were detected in both CAP and CAP + PPE populations; however, the percentage of viral co-detection was significantly higher in nasopharyngeal aspirates from CAP + PPE patients (35%) compared with CAP patients (5%). In conclusion, viral co-detection was observed mainly in patients with more severe pneumonia. Molecular biology assays improved the pathogens detection in pneumonia and confirmed the S. pneumoniae detection by BinaxNOW® in pleural effusion samples. Interestingly, the main S. pneumoniae serotypes found in PPE are not the ones targeted by the heptavalent pneumococcal conjugate vaccine.
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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
期刊介绍:
期刊最新文献
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