dc.contributor.author |
Samuel, Catherine M
|
en_ZA |
dc.contributor.author |
Whitelaw, Andrew
|
en_ZA |
dc.contributor.author |
Corcoran, Craig
|
en_ZA |
dc.contributor.author |
Morrow, Brenda
|
en_ZA |
dc.contributor.author |
Hsiao, Nei-Yuan
|
en_ZA |
dc.contributor.author |
Zampoli, Marco
|
en_ZA |
dc.contributor.author |
Zar, Heather
|
en_ZA |
dc.date.accessioned |
2015-11-18T03:46:35Z |
|
dc.date.available |
2015-11-18T03:46:35Z |
|
dc.date.issued |
2011 |
en_ZA |
dc.identifier.citation |
Samuel, C. M., Whitelaw, A., Corcoran, C., Morrow, B., Hsiao, N. Y., Zampoli, M., & Zar, H. J. (2011). Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study. BMC infectious diseases, 11(1), 329. |
en_ZA |
dc.identifier.uri |
http://hdl.handle.net/11427/15044
|
|
dc.identifier.uri |
http://dx.doi.org/10.1186/1471-2334-11-329
|
|
dc.description.abstract |
BACKGROUND: Pneumocystis pneumonia (PCP) is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT) specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT) specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1) to compare the diagnostic yield of PCR with immunofluorescence (IF) and (2) to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children. METHODS: Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA) and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL) were submitted for real-time PCR and direct IF for the detection of Pneumocystis jirovecii. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP. RESULTS: 202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months) were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52%) vs. 26/349 (7%) respectively; p < 0.0001]. PCR detected more infections compared to IF in lower respiratory tract samples [93/166 (56%) vs. 22/166 (13%); p < 0.0001] and in NPAs [87/183 (48%) vs. 4/183 (2%); p < 0.0001]. Detection rates by PCR on upper (87/183; 48%) compared with lower respiratory tract samples (93/166; 56%) were similar (OR, 0.71; 95% CI, 0.46 - 1.11). Only 2/30 (6.6%) controls were PCR positive. CONCLUSION: Real-time PCR is more sensitive than IF for the detection of P. jirovecii in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children. |
en_ZA |
dc.language.iso |
eng |
en_ZA |
dc.publisher |
BioMed Central Ltd |
en_ZA |
dc.rights |
This is an Open Access article distributed under the terms of the Creative Commons Attribution License |
en_ZA |
dc.rights.uri |
http://creativecommons.org/licenses/by/2.0 |
en_ZA |
dc.source |
BMC Infectious Diseases |
en_ZA |
dc.source.uri |
http://www.biomedcentral.com/bmcinfectdis/
|
en_ZA |
dc.subject.other |
Pneumocystis jirovecii |
en_ZA |
dc.subject.other |
Pneumocystis pneumonia (PCP) |
en_ZA |
dc.subject.other |
lower respiratory tract (LRT) |
en_ZA |
dc.subject.other |
HIV-infected African children |
en_ZA |
dc.title |
Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study |
en_ZA |
dc.type |
Journal Article |
en_ZA |
dc.rights.holder |
2011 Samuel et al; licensee BioMed Central Ltd. |
en_ZA |
uct.type.publication |
Research |
en_ZA |
uct.type.resource |
Article
|
en_ZA |
dc.publisher.institution |
University of Cape Town |
|
dc.publisher.faculty |
Faculty of Health Sciences |
en_ZA |
dc.publisher.department |
Division of Medical Microbiology |
en_ZA |
uct.type.filetype |
Text |
|
uct.type.filetype |
Image |
|
dc.identifier.apacitation |
Samuel, C. M., Whitelaw, A., Corcoran, C., Morrow, B., Hsiao, N., Zampoli, M., & Zar, H. (2011). Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/15044 |
en_ZA |
dc.identifier.chicagocitation |
Samuel, Catherine M, Andrew Whitelaw, Craig Corcoran, Brenda Morrow, Nei-Yuan Hsiao, Marco Zampoli, and Heather Zar "Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study." <i>BMC Infectious Diseases</i> (2011) http://hdl.handle.net/11427/15044 |
en_ZA |
dc.identifier.vancouvercitation |
Samuel CM, Whitelaw A, Corcoran C, Morrow B, Hsiao N, Zampoli M, et al. Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study. BMC Infectious Diseases. 2011; http://hdl.handle.net/11427/15044. |
en_ZA |
dc.identifier.ris |
TY - Journal Article
AU - Samuel, Catherine M
AU - Whitelaw, Andrew
AU - Corcoran, Craig
AU - Morrow, Brenda
AU - Hsiao, Nei-Yuan
AU - Zampoli, Marco
AU - Zar, Heather
AB - BACKGROUND: Pneumocystis pneumonia (PCP) is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT) specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT) specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1) to compare the diagnostic yield of PCR with immunofluorescence (IF) and (2) to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children. METHODS: Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA) and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL) were submitted for real-time PCR and direct IF for the detection of Pneumocystis jirovecii. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP. RESULTS: 202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months) were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52%) vs. 26/349 (7%) respectively; p < 0.0001]. PCR detected more infections compared to IF in lower respiratory tract samples [93/166 (56%) vs. 22/166 (13%); p < 0.0001] and in NPAs [87/183 (48%) vs. 4/183 (2%); p < 0.0001]. Detection rates by PCR on upper (87/183; 48%) compared with lower respiratory tract samples (93/166; 56%) were similar (OR, 0.71; 95% CI, 0.46 - 1.11). Only 2/30 (6.6%) controls were PCR positive. CONCLUSION: Real-time PCR is more sensitive than IF for the detection of P. jirovecii in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children.
DA - 2011
DB - OpenUCT
DO - 10.1186/1471-2334-11-329
DP - University of Cape Town
J1 - BMC Infectious Diseases
LK - https://open.uct.ac.za
PB - University of Cape Town
PY - 2011
T1 - Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study
TI - Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study
UR - http://hdl.handle.net/11427/15044
ER -
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en_ZA |