Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study
Background. Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Published: |
Oxford University Press
2017
|
| _version_ | 1797094070519070720 |
|---|---|
| author | Thea, DM Seidenberg, P Park, DE Mwananyanda, L Fu, W Shi, Q Baggett, HC Brooks, WA Feikin, DR Howie, SRC Knoll, MD Kotloff, KL Levine, OS Madhi, SA O’Brien, KL Scott, JAG Antonio, M Awori, JO Baillie, VL DeLuca, AN Driscoll, AJ Higdon, MM Hossain, L Jahan, Y Karron, RA Kazungu, S Li, M Moore, DP Morpeth, SC Ofordile, O Prosperi, C Sangwichian, O Sawatwong, P Sylla, M Tapia, MD Zeger, SL Murdoch, DR Hammitt, LL |
| author_facet | Thea, DM Seidenberg, P Park, DE Mwananyanda, L Fu, W Shi, Q Baggett, HC Brooks, WA Feikin, DR Howie, SRC Knoll, MD Kotloff, KL Levine, OS Madhi, SA O’Brien, KL Scott, JAG Antonio, M Awori, JO Baillie, VL DeLuca, AN Driscoll, AJ Higdon, MM Hossain, L Jahan, Y Karron, RA Kazungu, S Li, M Moore, DP Morpeth, SC Ofordile, O Prosperi, C Sangwichian, O Sawatwong, P Sylla, M Tapia, MD Zeger, SL Murdoch, DR Hammitt, LL |
| author_sort | Thea, DM |
| collection | OXFORD |
| description | Background. Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Methods. Among children aged 1-59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Results. Among 4232 cases with World Health Organization-defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41] ; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Conclusions. Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens. |
| first_indexed | 2024-03-07T04:09:02Z |
| format | Journal article |
| id | oxford-uuid:c733fe51-5d7a-487c-8060-a7c110e10f95 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T04:09:02Z |
| publishDate | 2017 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:c733fe51-5d7a-487c-8060-a7c110e10f952022-03-27T06:43:24ZLimited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c733fe51-5d7a-487c-8060-a7c110e10f95Symplectic Elements at OxfordOxford University Press2017Thea, DMSeidenberg, PPark, DEMwananyanda, LFu, WShi, QBaggett, HCBrooks, WAFeikin, DRHowie, SRCKnoll, MDKotloff, KLLevine, OSMadhi, SAO’Brien, KLScott, JAGAntonio, MAwori, JOBaillie, VLDeLuca, ANDriscoll, AJHigdon, MMHossain, LJahan, YKarron, RAKazungu, SLi, MMoore, DPMorpeth, SCOfordile, OProsperi, CSangwichian, OSawatwong, PSylla, MTapia, MDZeger, SLMurdoch, DRHammitt, LLBackground. Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Methods. Among children aged 1-59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Results. Among 4232 cases with World Health Organization-defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41] ; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Conclusions. Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens. |
| spellingShingle | Thea, DM Seidenberg, P Park, DE Mwananyanda, L Fu, W Shi, Q Baggett, HC Brooks, WA Feikin, DR Howie, SRC Knoll, MD Kotloff, KL Levine, OS Madhi, SA O’Brien, KL Scott, JAG Antonio, M Awori, JO Baillie, VL DeLuca, AN Driscoll, AJ Higdon, MM Hossain, L Jahan, Y Karron, RA Kazungu, S Li, M Moore, DP Morpeth, SC Ofordile, O Prosperi, C Sangwichian, O Sawatwong, P Sylla, M Tapia, MD Zeger, SL Murdoch, DR Hammitt, LL Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title | Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title_full | Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title_fullStr | Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title_full_unstemmed | Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title_short | Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study |
| title_sort | limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource poor settings findings from the pneumonia etiology research for child health perch study |
| work_keys_str_mv | AT theadm limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT seidenbergp limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT parkde limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT mwananyandal limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT fuw limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT shiq limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT baggetthc limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT brookswa limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT feikindr limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT howiesrc limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT knollmd limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT kotloffkl limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT levineos limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT madhisa limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT obrienkl limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT scottjag limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT antoniom limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT aworijo limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT baillievl limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT delucaan limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT driscollaj limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT higdonmm limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT hossainl limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT jahany limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT karronra limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT kazungus limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT lim limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT mooredp limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT morpethsc limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT ofordileo limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT prosperic limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT sangwichiano limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT sawatwongp limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT syllam limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT tapiamd limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT zegersl limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT murdochdr limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy AT hammittll limitedutilityofpolymerasechainreactionininducedsputumspecimensfordeterminingthecausesofchildhoodpneumoniainresourcepoorsettingsfindingsfromthepneumoniaetiologyresearchforchildhealthperchstudy |