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Detection of Pneumococcal DNA in Blood by Polymerase Chain Reaction for Diagnosing Pneumococcal Pneumonia in Young Children From Low- and Middle-Income Countries.


ABSTRACT: We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries.We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Additionally, we tested blood from general pediatric admissions in Kilifi, Kenya, a PERCH site. The proportion PCR-positive was compared among cases with microbiologically confirmed pneumococcal pneumonia (MCPP), cases without a confirmed bacterial infection (nonconfirmed), cases confirmed for nonpneumococcal bacteria, and controls.In PERCH, 7.3% (n = 291/3995) of cases and 5.5% (n = 273/4987) of controls were blood pneumococcal PCR-positive (P < .001), compared with 64.3% (n = 36/56) of MCPP cases and 6.3% (n = 243/3832) of nonconfirmed cases (P < .001). Blood pneumococcal PCR positivity was higher in children from the 5 African countries (5.5%-11.5% among cases and 5.3%-10.2% among controls) than from the 2 Asian countries (1.3% and 1.0% among cases and 0.8% and 0.8% among controls). Among Kilifi general pediatric admissions, 3.9% (n = 274/6968) were PCR-positive, including 61.7% (n = 37/60) of those with positive blood cultures for pneumococcus.The utility of pneumococcal PCR on blood for diagnosing childhood pneumococcal pneumonia in the 7 low- and middle-income countries studied is limited by poor specificity and by poor sensitivity among MCPP cases.

SUBMITTER: Morpeth SC 

PROVIDER: S-EPMC5447841 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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Detection of Pneumococcal DNA in Blood by Polymerase Chain Reaction for Diagnosing Pneumococcal Pneumonia in Young Children From Low- and Middle-Income Countries.

Morpeth Susan C SC   Deloria Knoll Maria M   Scott J Anthony G JAG   Park Daniel E DE   Watson Nora L NL   Baggett Henry C HC   Brooks W Abdullah WA   Feikin Daniel R DR   Hammitt Laura L LL   Howie Stephen R C SRC   Kotloff Karen L KL   Levine Orin S OS   Madhi Shabir A SA   O'Brien Katherine L KL   Thea Donald M DM   Adrian Peter V PV   Ahmed Dilruba D   Antonio Martin M   Bunthi Charatdao C   DeLuca Andrea N AN   Driscoll Amanda J AJ   Githua Louis Peter LP   Higdon Melissa M MM   Kahn Geoff G   Karani Angela A   Karron Ruth A RA   Kwenda Geoffrey G   Makprasert Sirirat S   Mazumder Razib R   Moore David P DP   Mwansa James J   Nyongesa Sammy S   Prosperi Christine C   Sow Samba O SO   Tamboura Boubou B   Whistler Toni T   Zeger Scott L SL   Murdoch David R DR  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20170601 suppl_3


<h4>Background.</h4>We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries.<h4>Methods.</h4>We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Addit  ...[more]

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