scholarly journals Comparison of Molecular Method and Culture in Detection of Community Acquired Pneumonia in Under Five Year Children in Assam, India

Author(s):  
Aparna Sonowal ◽  
Partha Pratim Das ◽  
Mithu Medhi ◽  
Aditi Baruah ◽  
Ezaz Hussain

Introduction: Pneumonia is the single largest infectious cause of death in children worldwide. Aetiology of pneumonia can be identified using multiple diagnostic tools including culture, serology and Polymerase Chain Reaction (PCR); common pathogens include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, some atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae. Aim: To find out the bacteriological agents causing Community Acquired Pneumonia (CAP) in under five year children and to compare the conventional culture and PCR in identifying the pathogen. Materials and Methods: This cross-sectional study was undertaken in the Department of Microbiology and Department of Paediatrics in a tertiary care centre of Assam, India, between March 2016 to September 2018. The study was undertaken with 200 under five year old children who were clinically diagnosed as CAP. Oropharyngeal (OP) swabs and blood culture were processed for bacteriological culture. PCR assay of OP swabs for Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus etc., including atypical bacteria like Mycoplasma pneumoniae and Chlamydophila pneumoniae were performed. Data entry, database management and statistical analysis were performed using Epi-Info software version 7.0. Results: A total of 200 subjects were included in the present study with a male:female ratio of 1.63:1. Most of the study subjects were <11 months of age. Most common isolates were Streptococcus pneumoniae (26.5%) and Staphylococcus aureus (25%) from OP swabs; blood culture revealed mostly Staphylococcus aureus (59%) and Streptococcus pneumoniae (25%). PCR assay of OP swabs were found positive mostly for Staphylococcus aureus (47%), Streptococcus pneumoniae (21.5%) while two children were positive for Haemophilus influenzae; Bordetella pertussis was detected in one child. On evaluation, PCR assay in detecting the bacterial pathogen was found statistically more significant than conventional culture of OP swabs (p<0.05). Conclusion: Staphylococcus aureus and Streptococcus pneumoniae were the most common bacterial organisms in the study. PCR assay was found to be more useful in diagnosing the pathogen for bacterial pneumonia including those difficult to grow in conventional culture.

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Sara A. Schutzman ◽  
Stephen Petrycki ◽  
Gary R. Fleisher

To investigate the occurrence and outcome of bacteremia associated with otitis media, charts were reviewed from patients who were 3 to 36 months of age, had temperatures ≥39°C, and were diagnosed with isolated clinical otitis media. A total of 2982 patients were identified. Blood cultures were obtained from 1666 (56%). Of the 1666 patients, who had blood drawn for cultures, 50 (3.0%) had bacteremia. These included 39 with Streptococcus pneumoniae, 4 with Haemophilus influenzae, 2 with Neisseria meningitidis, 3 with Salmonella species, and 2 with Staphylococcus aureus. The incidence of bacteremia increased at higher temperatures, being 1.9% at temperatures ≤40°C and 5.0% at temperatures &gt;40°C. Younger children were more likely to have bacteremia; 3.7% ≤12 months of age, 2.4% 13 to 24 months of age, and 1.9% 25 to 36 months of age had blood culture results that were positive (not significant). Reevaluation of the 50 bacteremic patients showed that 9 patients had continued fever, 3 patients had persistent bacteremia, pneumonia developed in 1 patient, and meningitis developed in 1 patient. It was concluded that (1) 3% of young febrile children with otitis media have bacteremia at the time of evaluation, a rate comparable to that previously reported in children with no focus of infection; (2) the incidence of bacteremia increases at higher temperatures; and (3) most febrile children with otitis media do well. The clinician must therefore weigh the potential benefit of drawing a blood culture to identify children at risk for complications against the inherent cost, inconvenience, and discomfort.


2005 ◽  
Vol 54 (4) ◽  
pp. 395-400 ◽  
Author(s):  
Naoyuki Miyashita ◽  
Hiroshi Fukano ◽  
Keiji Mouri ◽  
Minoru Fukuda ◽  
Koichiro Yoshida ◽  
...  

In this study the aetiology of community-acquired pneumonia (CAP) in Japan was investigated and the incidence of causative pathogens in ambulatory and hospitalized patients was compared. In addition, the roles of Chlamydophila felis and Chlamydophila pecorum as causes of CAP were investigated. Five hundred and six patients with CAP who visited an outpatient clinic or were admitted to one of three different hospitals were enrolled in this study; 106 of them were outpatients and 400 were hospitalized patients. Among the 506 CAP cases, Mycoplasma pneumoniae was the most common pathogen found in the outpatients and Streptococcus pneumoniae was the most common in the hospitalized patients. No cases of Chlamydophila pecorum pneumonia were observed and only one patient had an antibody titre suggestive of recent infection with the feline strain of Chlamydophila. The incidence of infection with M. pneumoniae and Chlamydophila pneumoniae was higher among the outpatients than among hospitalized patients, whereas the incidence of infection with S. pneumoniae and Haemophilus influenzae was higher among the hospitalized patients. Recognition of these results will allow prompt and appropriate antimicrobial therapy to be provided using Japanese CAP guidelines.


1996 ◽  
Vol 34 (8) ◽  
pp. 2030-2032 ◽  
Author(s):  
M Hassan-King ◽  
I Baldeh ◽  
R Adegbola ◽  
C Omosigho ◽  
S O Usen ◽  
...  

2021 ◽  
Vol 74 (1) ◽  
pp. 43-48
Author(s):  
А.А. Елеукина ◽  
А.Н Коржумбаев . ◽  
А.Р. Акшалов ◽  
К.Е. Капезов ◽  
Абдихалилов

Внебольничные пневмонии (ВП) представляют серьезную проблему инфекционной патологии человека и являются одной из ведущих причин смерти от инфекционных болезней. По данным ВОЗ, инфекции нижних дыхательных путей занимают 3-е место (после инфаркта и инсульта) в мировой статистике летальных исходов 2011 г. Ведущими возбудителями ВП являются Streptococcus pneumoniae, Haemophilus influenzae, бактерии семейства Enterobacteriaceae – Klebsiella pneumoniae, Escherichia coli и др., Staphylococcus aureus. К известным атипичным бактериальным возбудителям ВП относятся такие микроорганизмы, как Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, Chlamydophila psittaci и Coxiella burnetii. Возбудителями ВП могут быть и респираторные вирусы, наиболее часто – вирусы гриппа, коронавирусы, риносинцитиальный вирус (РС-вирус), метапневмовирус и бокавирус человека. При ВП может иметь место ко-инфекция двумя и более возбудителями, вызванная как ассоциацией различных бактериальных возбудителей, так и их сочетанием с респираторными вирусами. Частота встречаемости ВП, вызванной ассоциацией возбудителей, варьирует от 3 до 40 % Пандемия новой коронавирусной инфекции сопровождается высоким уровнем заболеваемости ВП, с большой долей осложненных и затяжных случаев. Известно, что вирусы вызывают нарушения работы иммунной системы, что делает людей более восприимчивыми к другим патогенам. G. Zahariadis et al. в 2006 г., основываясь на результатах серологических исследований пациентов, перенесших ОРВИ, выявили случаи острой или недавней инфекции C. pneumoniae (30 %) или M. pneumoniae (9 %). Многоцентровое ретроспективное когортное исследование пациентов с тяжелым течением Ближневосточного респираторного синдрома, вызванного коронавирусом (БВРС-КоВ), показало, что 18 и 5 % имели бактериальные и вирусные коинфекции соответственно. Предыдущие исследования показали, что коронавирус наносит серьезный удар по иммунной системе человека. Например, одним из наиболее распространенных симптомов у пациентов с COVID-19 является временное или стойкое снижение уровня лимфоцитов в крови. Разрушение иммунных клеток вирусом SARS-CoV-2 делает пациентов уязвимыми к вторичным бактериальным инфекциям. Пневмония у пациентов с COVID-19 отличается от SARS-CoV-2- негативной внебольничной пневмонии. При тяжѐлом течении COVID-19 несомненна роль в альтерации органов и тканей синдрома активации макрофагов (вторичного гемофагоцитарного лимфогистиоцитоза) и нерегулируемого выброса цитокинов и хемокинов (цитокиновый шторм) с нарушением продукции интерлейкинов, функции Тлимфоцитов, с истощением клеточного иммунного ответа и лимфопенией. Не исключается также развитие вирусиндуцированных аутоиммунных реакций. Системное поражение вирусом и цитокиновым штормом эндотелия (микроангиопатия с его повреждением, реже эндотелиит и васкулит) и активация каскада коагуляции при COVID-19 вызывают гиперкоагуляционный синдром c тромбозами и тромбоэмболиями. Также отмечаются одновременное поражение других органов, которое становится непосредственной причиной смерти, а также сепсис и септический шок при присоединении бактериальной. Одним из ярких маркеров наличия и тяжести воспалительной реакции в организме при COVID-19 является С-реактивный белок (СРБ, CRP – от англ. C-reactive protein). До настоящего времени в большинстве публикаций он рассматривался, в первую очередь, как маркер присоединения бактериальной инфекции, требующей применения антибиотиков, что по уровню СРБ можно было дифференцировать вирусную и бактериальную этиологию пневмонии. Иммунологические исследования показали, что при проникновении вируса SARS-CoV-2 в организм запускается иммунный ответ для борьбы с этим патогеном, что также приводит к повышению уровня СРБ. Концентрация в крови достоверно повышается более популяционно значимого уровня (5 мг/л) уже в течение первых 4–6 ч от момента альтерации, достигая максимума в течение 48 ч (24–72 ч – в зависимости от тяжести патологического процесса). Более того, известно, что она удваивается каждые первые 8 ч, достигая максимума через 36–50 ч, а на фоне тяжелого генерализованного системного воспаления может возрастать в короткое время в 100 и более раз.


Respiration ◽  
2007 ◽  
Vol 75 (4) ◽  
pp. 437-442 ◽  
Author(s):  
G. Eda Utine ◽  
Ahmet Pinar ◽  
Uğur Özçelik ◽  
Burçin Şener ◽  
Ebru Yalçin ◽  
...  

2017 ◽  
Vol 34 (3) ◽  
pp. 128-134
Author(s):  
Md Abdus Salam ◽  
Md Robed Amin ◽  
Quazi Tarikul Islam

Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134


Author(s):  
Mirela C. M. Prates ◽  
Edwin Tamashiro ◽  
José L. Proenca-Modena ◽  
Miriã F. Criado ◽  
Tamara H. Saturno ◽  
...  

We sought to investigate the prevalence of potentially pathogenic bacteria in secretions and tonsillar tissues of children with chronic adenotonsillitis hypertrophy compared to controls. Prospective case-control study comparing patients between 2 and 12 years old who underwent adenotonsillectomy due to chronic adenotonsillar hypertrophy to children without disease. We compared detection of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, and Moraxella catarrhalis by real-time PCR in palatine tonsils, adenoids, and nasopharyngeal washes obtained from 37 children with and 14 without adenotonsillar hypertrophy. We found high frequency (>50%) of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Pseudomonas aeruginosa in both groups of patients. Although different sampling sites can be infected with more than one bacterium and some bacteria can be detected in different tissues in the same patient, adenoids, palatine tonsils, and nasopharyngeal washes were not uniformly infected by the same bacteria. Adenoids and palatine tonsils of patients with severe adenotonsillar hypertrophy had higher rates of bacterial coinfection. There was good correlation of detection of Moraxella catarrhalis in different sampling sites in patients with more severe tonsillar hypertrophy, suggesting that Moraxella catarrhalis may be associated with the development of more severe hypertrophy, that inflammatory conditions favor colonization by this agent. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Moraxella catarrhalis are frequently detected in palatine tonsils, adenoids, and nasopharyngeal washes in children. Simultaneous detection of Moraxella catarrhalis in adenoids, palatine tonsils, and nasopharyngeal washes was correlated with more severe tonsillar hypertrophy.


2018 ◽  
Vol 59 (4) ◽  
pp. 1-10
Author(s):  
Samuel Martínez Vernaza ◽  
Maria Juliana Soto Chavez ◽  
Estefania Mckinley ◽  
Sandra Gualtero Trujillo

La neumonía adquirida en la comunidad (NAC) continúa siendo una de las principales causas de mortalidad en Colombia, pues es responsable de 13 de cada 100.000 muertes. Su principal agente etiológico es el Streptococcus pneumoniae, seguido por Haemophilus influenzae y Staphylococcus aureus. Se han identificado algunos factores de riesgo como comorbilidades y factores de exposición epidemiológica, los cuales incrementan la posibilidad de contraer una infección por microrganismos específicos. Su diagnóstico debe basarse tanto en la clínica como en hallazgos paraclínicos e imagenológicos. Herramientas como las escalas CURB-65 y PSI asociadas al criterio clínico permiten calcular el riesgo de mortalidad y el área de atención del paciente según su clasificación. En esta revisión se consideran los diferentes elementos para una adecuada evaluación y manejo del paciente que cursa con NAC, el uso de algunos biomarcadores, situaciones especiales para apreciar, como la neumonía severa, y estrategias para una adecuada prevención.


2013 ◽  
Vol 65 (1) ◽  
pp. 14
Author(s):  
José M Guevara ◽  
Rosaluz Aróstegui ◽  
Wini Agurto ◽  
Iliana Sobrevilla ◽  
Esther Valencia ◽  
...  

OBJETIVO: Determinar la resistencia de los patógenos respiratorios a diferentes antimicrobianos. MATERIAL Y MÉTODOS: Entre abril y noviembre de 2002 se estudió 177 pacientes que asistieron al consultorio externo de otorrinolaringología del Hospital Nacional Docente Madre-Niño San Bartolomé. RESULTADOS: Streptococcus pneumoniae fue la bacteria patógena más aislada (57,2%), luego Moraxella catarrhalis (42,7%), Staphylococcus aureus (18,6%) y en pequeña cantidad Haemophilus influenzae (3,4%) y Streptococcus pyogenes (0,7%). Streptococcus pneumoniae presentó 31,3% de resistencia a la penicilina. El 96,7% de Moraxella catarrhalis fueron productoras de betalactamasa y 7,4% de los Staphylococcus aureus fueron resistentes a la oxacilina. CONCLUSIÓN: Streptococcus pneumoniae es el principal agente causal de los procesos infecciosos altos en niños y su resistencia a la penicilina aumentó a 31,3%


2020 ◽  
Vol 7 (12) ◽  
pp. 5144-5153
Author(s):  
Abu Kausar Mohammad ◽  
Morshed Nasir ◽  
Sujat Paul ◽  
Habibur Rahman ◽  
Kalam Abul ◽  
...  

Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. Community-acquired pneumonia (CAP) is associated with a significant mortality and morbidity. Knowledge of predominant microbial patterns in CAP constitutes the basis for initial decisions about empirical antimicrobial treatment. The aim of this study was to identify the bacterial etiology of CAP in adult hospitalized patients and to see their antibiotic sensitivity pattern. It was a hospital based cross sectional observational study on 87 hospitalized patients diagnosed with CAP admitted in Medicine department of Chittagong Medical College Hospital (CMCH). Sputum for Gram staining, Z N staining, culture sensitivity, blood culture and sensitivity and PCR for Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumonia and Streptococcus pneumonia were done. Patients were followed up for in-hospital outcome and 30-day mortality. The mean (±SD) age was 49.59±16.97 years and male female ratio was 1.56:1. Sputum culture, blood culture and PCR were positive in 60.9%, 1.1% and 4.6% of the samples respectively. Klebsiella pneumoniae was identified in the sputum culture of the majority of the patients (39.1%), followed by Pseudomonas aeruginosa (10.3%), Staphylococcus aureus and Escherichia coli (5.7%). The only one sample which was positive in blood culture and it was Staphylococcus aureus. Streptococcus pneumoniae was identified in all the 4 PCR positive cases. The highly sensitive drugs were meropenem, levofloxacin and amikacin. In hospital mortality and 30-day mortality was 6.9% and 16.1% respectively. Gram-negative bacteria pre-dominate in the bacteriologic profile of CAP using conventional sputum and blood culture. There is need for further conventional serologic tests for atypical and viral pathogens in all patients admitted with CAP.


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