#16: Use of a Multiplex PCR Panel for Diagnosis of Complicated Pneumonia in Pediatrics

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Elisa A Armas ◽  
M Melgar ◽  
J Juárez ◽  
M Vidal ◽  
J Eguizábal ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiplex Pcr ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Positive Culture ◽  
Descriptive Study ◽  
Guatemala City ◽  
Etiological Diagnosis ◽  
Roosevelt Hospital ◽  
Complicated Pneumonia

Abstract Background Pleural fluid cultures performed in the period from April 2015 to April 2017 (prior to having the test) were reviewed, 120 cultures were found, of which 7.5% were positive. Methods Descriptive study in patients from 0 to 12 years old, from April 2017 to April 2019, at Roosevelt Hospital, Guatemala City, June 2019 Results In the period from April 2017 to April 2019, pleural fluids were evaluated in which multiplex PCR was performed, obtaining 41 results, 24 positive PCR for pneumonia producing bacteria in the community, of which only 1 positive culture was found, which, if correlated, which means 25 times more detection capacity, than the Gold standard of culture. Forty-one cultures of pleural fluids were evaluated, of which 58% were detected by FilmArray® The most frequently isolated microorganisms were Streptococcus pneumoniae 42%, Streptococcus sp. 3% Haemophilus influenzae 13% and Pseudomonas aeruginosa 3% Conclusion The use of Multiplex PCR in pleural fluid allowed the identification of a high percentage of microorganisms in the pleural fluid. Although the test is not valid for this use, its use could mean a great advantage for the etiological diagnosis.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

Diagnostic Value of Multiplex Polymerase Chain Reaction in Detection of Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia from Sepsis in Pediatrics

2021 ◽  
Vol 15 ◽  
Author(s):  
Sara Galeb ◽  
Maysaa El Sayed Zaki ◽  
Raghdaa Shrief ◽  
Rasha Hassan ◽  
Mohamed Anies
Keyword(s):  
Polymerase Chain Reaction ◽  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Multiplex Pcr ◽  
Stenotrophomonas Maltophilia ◽  
Multiplex Polymerase Chain Reaction ◽  
Diagnostic Value ◽  
Blood Cultures ◽  
Chain Reaction ◽  
Polymerase Chain

Background: Proper identification of the causative organism in pediatric sepsis is crucial for early diagnosis and prevention of septic shock and organ failure. Objectives: The present study aimed to evaluate the multiplex Polymerase Chain Reaction (PCR) to detect Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia from positive blood cultures for these pathogens isolated from children, with hospital-acquired sepsis compared to the conventional biochemical reactions for identification of these organisms. Methods: This study was a cross-sectional study performed on 100 isolates from pediatric blood cultures, including Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The study also included 100 isolates of Escherichia coli as a negative control. All isolates were identified by API 20NE and the multiplex PCR, with primers specific to the 3 tested bacteria. Results: Multiplex PCR was positive in 96% of isolates, and 4 isolates had negative results. False positive results were reported with three E. coli strains. Multiplex PCR identified all the isolates of Acinetobacter baumannii, 29 isolates of Pseudomonas aeruginosa, and 27 isolates of Stenotrophomonas maltophilia. Compared to the biochemical identification, the diagnostic value of the multiplex PCR revealed 96.04% sensitivity, 96.9% specificity, 97.00%, positive predictive value, 96.00% negative predictive value, and 96.50% accuracy. Conclusion: The present study highlights the diagnostic value of multiplex PCR to identify Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia from positive blood cultures. Multiplex PCR was sensitive, specific, and accurate. The accuracy differs according to the organisms, with 100% accuracy for Acinetobacter baumannii.

scholarly journals Hasil diagnostik Mycobacterium tuberculosis dengan pewarnaan Ziehl-Neelsen pada penderita batuk ≥2 minggu di Puskesmas Ranotana, Puskesmas Wenang, dan Puskesmas Sario Manado

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ireine S. Waworuntu ◽  
John . Porotu'o ◽  
Olivia A. Waworuntu
Keyword(s):  
Public Health ◽  
Mycobacterium Tuberculosis ◽  
Gold Standard ◽  
Sampling Method ◽  
Public Health Service ◽  
Descriptive Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Cross Sectional Design ◽  
The Right

Abstract: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis). In Indonesia, there are about 430.000 new cases, of which 61.000 cases ended in death. This disease has many clinical varieties, therefore, a gold standard for the right and exact diagnosis is needed. The examination of sputum by using Ziehl-Neelsen staining must be more improved for public health service. This study aimed to determine the profile of Mycobacterium tuberculosis (acid-fast bacteria) among patients with coughing ≥2 weeks at Ranotana, Wenang and Sario Primary Health Cares (PHCs) by using Ziehl-Neelsen staining. This was a descriptive study with a cross sectional design. Samples were obtained by using total sampling method during the period of September 2015 - December 2015. The results showed that there were 38 cases of coughing ≥2 weeks as follows: 15 cases at Wenang PHC, 13 cases at Ranotana PHC, and 10 cases at Sario PHC. The examination of acid-fast bacteria from the 38 cases of three PHCs showed that 1 case (2.7%) had acid-fast bacteria (++). Conclusion: In this study, there was only one case (2,7%) with positive Mycobacterium tuberculosis. Keywords: cough more than two weeks, tuberculosis, BTA Abstrak: Tuberkulosis adalah suatu penyakit infeksi yang disebabkan oleh Mycobacterium tuberculosis (M. tuberculosis). Indonesia memiliki sekitar 430.000 kasus baru dimana 61.000 kasus berakhir dengan kematian. Penyakit ini memiliki gejala klinis yang bervariasi sehingga perlu ditetapkan standar baku untuk menegakkan diagnosis lebih cepat dan akurat. Pemeriksaan sputum dengan pewarnaan Ziehl-Neelsen harus lebih ditingkatkan pada pelayanan kesehatan masyarakat. Penelitian ini bertujuan untuk mendapatkan gambaran Mycobacterium tuberculosis (basil tahan asam, BTA) dengan pewarnaan Ziehl-Neelsen pada pasien batuk ≥2 minggu di Puskesmas Wenang, Puskesmas Ranotana, dan Puskesmas Sario Kota Manado. Jenis penelitian ini deskriptif dengan desain potong lintang. Pengambilan sampel menggunakan cara total sampling pada kurun waktu September 2015 - Desember 2015. Hasil penelitian mendapatkan 38 kasus batuk ≥2 minggu yaitu 15 kasus di Puskesmas Wenang, 13 kasus di Puskesmas Ranotana dan 10 kasus di Puskesmas Sario. Pada pemeriksaan (BTA) di Puskesmas Wenang, Puskesmas Ranotana dan Puskesmas Sario didapatkan BTA (++) 2,7% sedangkan BTA (-) 97,3%.Simpulan: Pada penelitian ini didapatkan 1 kasus (2,7%) Mycobacterium tuberculosis positif

scholarly journals LAPAROSCOPY;

2012 ◽  
Vol 19 (01) ◽  
pp. 033-039
Author(s):  
NAZIA MUSSARAT ◽  
SIAMA QURESHI ◽  
AWAIS SHUJA ◽  
Mehnaaz Roohi
Keyword(s):  
Abdominal Pain ◽  
Gold Standard ◽  
Open Surgery ◽  
Diagnostic Laparoscopy ◽  
Data Entry ◽  
Lower Abdominal Pain ◽  
Descriptive Study ◽  
Lower Abdomen ◽  
Patient Case ◽  
Polycystic Ovarian Disease

Introduction: Diagnostic Laparoscopy is considered to be the gold standard for the evaluation of the pelvis and is considered asafe procedure. Diagnostic Laparoscopy is a technique in the routine investigation and treatment of infertility as well as other gynecologicalproblems. Objectives: To determine, Laparoscopic findings in different gynecological conditions, different causes of infertility andcomplications of laparoscopy Design: Retrospective, descriptive study. Material And Methods: We reviewed case records of all patients whounderwent laparoscopy for their different Gynecological problems. Data were collected from patient case records in a data entry sheet Results:In our study a total of Thirty patients under went laparoscopy for investigation of different gynecological problems. There were 17 patients whohave primary infertility and 6 have secondary infertility while 7 presented with Lower abdominal pain. In our study the leading cause of primaryinfertility was Polycystic Ovarian Disease(29%).Other causes were bilateral tubal blockade (23.53 %) ,17% has PID and fibroid uteri, While onepatients shown Endometriosis as well as one patient had no obvious pathology.(5.88 %).On laparoscopic examination of secondaryinfertility 50% shown Tubal blocked while 16.67 shown Fibroid uterus and PID.One patient had normal pelvic findings(16.67). Regardingpatients presented with pain lower abdomen 57.15% has ovarian cyst,28.58% has Ectopic pregnancy while one case(14.29%) had hetrotropicpregnancy. In 24 patients had no complication and recovery was smooth. laparoscopy had to be converted into Laparotomy due to significanthemorrhage in two patient and wound infection was observed in two patients. One patient presented with post operative fever and onepresented with abdominal pain. Conclusions: Laparoscopy is a valuable diagnostic tool for females in different gynecological problems. Thebenefit of the laparoscopy to open surgery include less pain, less scarring, less disability and quicker recovery.

scholarly journals Serotype Distribution of Streptococcus pneumoniae Carriage ‎in Six-Month-Old Infants: A Cross-sectional Study During 2017-18, Tehran, ‎Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Shirin Sayyahfar ◽  
Abdoulreza Esteghamati ◽  
Seyed Alireza Fahimzad ◽  
Safura Hajisadeghi Isfahani ◽  
Ali Nazari Alam ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Multiplex Pcr ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Serotype Distribution ◽  
Cross Sectional ◽  
Non Invasive ◽  
Healthy Infants ◽  
Invasive Infections

Background: Streptococcus pneumoniae is recognized as one of the main pathogens inducing several invasive and non-invasive infections in children. Objective: The present study aimed to evaluate the serotype distribution of S. pneumoniae in six–month–old carriers. Methods: This study encompassed 600 six-month-old healthy infants whose pharyngeal swap samples were collected and then cultured to isolate S. pneumoniae. Twenty- five different serotypes were defined on positive culture samples by multiplex PCR. Results: In this study, 13 cases (2.2%) were positive S. pneumonia. The most common isolated serotypes of S. pneumoniae were serotypes 23F (n = 6, 1%) and 3 (n = 3, 0.5%), respectively. Notably, the most frequent serotype in formula-fed infants (n = 300) was Serotype 23F (n = 5, 1.7%); however, Serotype 3 (n = 3, 1%) was the most frequent one in breastfed participants (n = 300). According to the findings, the overall coverage of PCV10, PCV13, and PPSV23 on the S. pneumoniae serotypes at the age of six months was 50%, 73%, and 85%, respectively. Conclusions: At this age, the type of feeding could not significantly affect the frequency rate of S. pneumoniae colonization, while the serotype distributions in the two breastfed and formula-fed groups were different.

A universal primer multiplex PCR method for typing of toxinogenic Pseudomonas aeruginosa

2012 ◽  
Vol 95 (6) ◽  
pp. 1579-1587 ◽  
Author(s):  
Hui Shi ◽  
Quoclinh Trinh ◽  
Wentao Xu ◽  
Baiqiang Zhai ◽  
Yunbo Luo ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multiplex Pcr ◽  
Universal Primer ◽  
Pcr Method

scholarly journals Role of Combined Pleural Fluid Cholesterol and Total Protein in Differentiation of Exudates and Transudates

2020 ◽  
Vol 3 (1) ◽  
pp. 282-285
Author(s):  
Anupam Bista ◽  
Suman Thapa ◽  
Prasant Subedi ◽  
Kiran Manandhar
Keyword(s):  
Pleural Fluid ◽  
Standard Method ◽  
Total Protein ◽  
Gold Standard ◽  
Pleural Effusions

Introduction: Light's criteria had been the standard method for distinguishing exudative and transudative pleural effusions which misidentify 15-20% of transudates as exudates. This study aims to find out the role of combined pleural fluid cholesterol and total protein in distinguishing exudative from transudative pleural effusions and its applicability in Nepalese populations. Materials and Methods: Patients with pleural effusions were enrolled for the study. The combined pleural fluid cholesterol and total protein were compared with Light’s criteria and also compared with the diagnosis on discharge to find out their usefulness in categorizing the pleural effusions. Results: A total of 81 patients enrolled in the study, 42 (51.9%) were male. Based on Light’s criteria, 88.8% pleural effusions were found to be exudates and 11.1% were found to be transudates. Within the criteria, Light’s criteria categorized more pleural fluids as exudates than the diagnosis on discharge. Based on pleural fluid cholesterol >60mg/dL and protein >3g/dL for the classification of exudative and transudative pleural fluid, 62.9% out of 81 samples felled under the exudates and 37.03% pleural effusions under transudates with the sensitivity 87.9% and specificity 100%. Conclusions: Though Light’s criteria remain the gold standard to differentiate transudates and exudates, combined pleural fluid cholesterol and total protein give nearly comparable results without the need for simultaneous blood investigations.

scholarly journals Pseudomonas aeruginosa eradication therapy and risk of acquiring Aspergillus in young children with cystic fibrosis

Thorax ◽  
2019 ◽  
Vol 74 (8) ◽  
pp. 740-748 ◽  
Author(s):  
Sabariah Noor Harun ◽  
Nicholas H G Holford ◽  
Keith Grimwood ◽  
Claire E Wainwright ◽  
Stefanie Hennig
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Young Children ◽  
Bronchoalveolar Lavage ◽  
Eradication Therapy ◽  
Positive Culture ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Increased Risk ◽  
Sectional Analysis

BackgroundWhile Aspergillus detection rates in adults, adolescents and older children with cystic fibrosis (CF) have increased, the risk of acquiring this fungal pathogen in young children is unknown.AimTo determine the risk and explanatory factors of acquiring Aspergillus in children with CF by age 5 years.MethodsCross-sectional analysis of clinical, bronchoalveolar lavage and treatment data from the Australasian Cystic Fibrosis Bronchoalveolar Lavage study was used to identify predictive factors for detecting Aspergillus at age 5 years. A parametric repeated time-to-event model quantitatively described the risk and factors associated with acquiring Aspergillus and Pseudomonas aeruginosa from birth until age 5 years.ResultsCross-sectional analysis found that the number of P. aeruginosa eradication courses increased the odds of detecting Aspergillus at age 5 years (OR 1.61, 95% CI 1.23 to 2.12). The median (IQR) age for the first P. aeruginosa positive culture was 2.38 (1.32–3.79) years and 3.69 (1.68–4.74) years for the first Aspergillus positive culture. The risk of P. aeruginosa and Aspergillus events changes with time after the first year of study entry. It also decreases for P. aeruginosa after completing P. aeruginosa eradication (HR 0.15, 95% CI 0.00 to 0.79), but increases for Aspergillus events (HR 2.75, 95% CI 1.45 to 5.41). The risk of acquiring both types of events increases after having had a previous event.ConclusionIn young children with CF, completing P. aeruginosa eradication therapy and previous Aspergillus events are associated with increased risk of acquiring Aspergillus.

70% Alcohol Disinfection of Transducer Heads: Experimental Trials

1985 ◽  
Vol 6 (6) ◽  
pp. 237-239 ◽  
Author(s):  
George H. Talbot ◽  
Maureen Skros ◽  
Mary Provencher
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Room Temperature ◽  
Positive Culture ◽  
Cost Effective ◽  
Enterobacter Cloacae ◽  
Safety And Efficacy ◽  
Single Positive ◽  
Cost Effective Alternative ◽  
Experimental Trials

AbstractWe investigated the feasibility of transducer head disinfection with 70% alcohol wipes. In the initial trial, nine gas-sterilized transducers were inoculated with an estimated 5 × 106 organisms of a clinical isolate of Enterobacter cloacae, mimicking a contaminated fluid couple. A sterile disposable transducer dome was attached to each transducer. The units were allowed to sit for 24 hours at room temperature; the domes were then removed. Three transducer heads were cultured prior to disinfection to ensure that viable organisms remained. Each transducer head was wiped clean with a single alcohol wipe, allowed to dry, and then cultured. All nine cultures showed growth of E. cloacae. A second series of trials with 54 transducers employed an identical protocol, except that each transducer head received not one, but two, applications of alcohol. In addition to E. cloacae (26 runs), Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were employed in nine, nine and ten runs, respectively. Cultures of 53 of 54 transducer heads showed no growth; the single positive culture was attributed to an error in technique. These preliminary results suggest that the double-alcohol-wipe technique may be an easy, cost-effective, alternative or supplemental method of transducer head disinfection. However, we do not advocate routine implementation of this technique in patient care settings until clinical trials confirm its safety and efficacy.

Comparison evaluation between gene Xpert Mtb/Rif and multiplex PCR for rapid diagnosis of mycobacterium tuberculosis

2020 ◽  
pp. 1-11
Author(s):  
Saira Salim ◽  
Wajid Hussain ◽  
Gohar Zaman ◽  
Umer Khurshid ◽  
Luqman Satti ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Multiplex Pcr ◽  
Gold Standard ◽  
Empirical Therapy ◽  
Armed Forces ◽  
Negative Control ◽  
Cross Sectional ◽  
Limited Region ◽  
Sensitivity Specificity ◽  
Culture Positive

Abstract Objective: To evaluate Gene Xpert MTB/RIF and Multiplex PCRfor detection of Mycobacterium tuberculosis and Rifampicin resistance comparing with gold standard MGIT 960. It was cross sectional validation study. Methods: This study had been carried out at Department of Microbiology Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan from March 2018 to October 2018.MGIT 960 culture system MTB positive Rifampicin (RIF) resistant and RIF susceptible (negative control) samples were taken. Gene Xpert MTB / RIF assay and Multiplex PCR were applied simultaneously and compared with gold standard MGIT 960. Results: Out of 192 samples evaluated, 84(44%) were culture positive RIF resistant and 108(56%) were culture positive RIF susceptible as negative control. Out of total culture positive RIF resistant, all 84 were found positive for MTB by Gene Xpert MTB /RIF assay and Multiplex PCR method. Gene Xpert MTB/RIF assay detected all 84 RIF culture resistant samples for Rif resistance. Multiplex PCR detected only 44 RIF culture resistant, while remaining 40 did not showed resistance to rpoB gene codon 531 region. Sensitivity, Specificity, PPV and NPV of Gene Xpert MTB/RIF were 100% each respectively. Sensitivity, Specificity, PPV and NPV of Multiplex PCR for detection of RIF resistance were 52%, 100%, 100%, 72% respectively. Conclusion: Molecular detection of MTB and RIF resistant by Gene Xpert MTB/ RIF and Multiplex PCR simultaneously is rapid and cost effective method. Both methods can help clinician to initiate early empirical therapy to patient in resource limited region. Keywords: RIF, Gene Xpert MTB/ RIF, Multiplex PCR.

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