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dc.contributor.authorBjarnason, A
dc.contributor.authorLindh, M
dc.contributor.authorWestin, J
dc.contributor.authorAndersson, L-M
dc.contributor.authorBaldursson, O
dc.contributor.authorKristinsson, K G
dc.contributor.authorGottfredsson, M
dc.date.accessioned2017-04-10T12:48:31Z
dc.date.available2017-04-10T12:48:31Z
dc.date.issued2017-03
dc.date.submitted2017
dc.identifier.citationUtility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults. 2017, 36 (3):529-536 Eur. J. Clin. Microbiol. Infect. Dis.en
dc.identifier.issn1435-4373
dc.identifier.pmid27822652
dc.identifier.doi10.1007/s10096-016-2829-z
dc.identifier.urihttp://hdl.handle.net/2336/620146
dc.descriptionEfst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn To access publisher's full text version of this article click on the hyperlink at the bottom of the pageor click on the hyperlink at the To access publisher's full text version of this article, please click on the hyperlink in Additional Links field top of the page marked Filesen
dc.description.abstractA lack of sensitive tests and difficulties obtaining representative samples contribute to the challenge in identifying etiology in pneumonia. Upper respiratory tract swabs can be easily collected and analyzed with real-time PCR (rtPCR). Common pathogens such as S. pneumoniae and H. influenzae can both colonize and infect the respiratory tract, complicating the interpretation of positive results. Oropharyngeal swabs were collected (n = 239) prospectively from adults admitted to hospital with pneumonia. Analysis with rtPCR targeting S. pneumoniae and H. influenzae was performed and results compared with sputum cultures, blood cultures, and urine antigen testing for S. pneumoniae. Different Ct cutoff values were applied to positive tests to discern colonization from infection. Comparing rtPCR with conventional testing for S. pneumoniae in patients with all tests available (n = 57) resulted in: sensitivity 87 %, specificity 79 %, PPV 59 % and NPV 94 %, and for H. influenzae (n = 67): sensitivity 75 %, specificity 80 %, PPV 45 % and NPV 94 %. When patients with prior antimicrobial exposure were excluded sensitivity improved: 92 % for S. pneumoniae and 80 % for H. influenzae. Receiver operating characteristic curve analysis demonstrated for S. pneumoniae: AUC = 0.65 (95 % CI 0.51-0.80) and for H. influenzae: AUC = 0.86 (95 % CI 0.72-1.00). Analysis of oropharyngeal swabs using rtPCR proved both reasonably sensitive and specific for diagnosing pneumonia caused by S. pneumoniae and H. influenzae. This method may be a useful diagnostic adjunct to other methods and of special value in patients unable to provide representative lower airway samples.
dc.description.sponsorshipIcelandic Center for Research Rannis Landspitali University Hospital Science Fund University of Iceland Research Funden
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309271/pdf/10096_2016_Article_2829.pdfen
dc.rightsArchived with thanks to European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen
dc.subjectLungnabólgaen
dc.subjectSjúkdómsgreiningaren
dc.subjectBakteríusjúkdómaren
dc.subjectSýkingaren
dc.subjectTMD12en
dc.subjectBAC12en
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshFemaleen
dc.subject.meshHaemophilus influenzaeen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMolecular Diagnostic Techniquesen
dc.subject.meshOropharynxen
dc.subject.meshPneumonia, Bacterialen
dc.subject.meshPredictive Value of Testsen
dc.subject.meshProspective Studiesen
dc.subject.meshROC Curveen
dc.subject.meshReal-Time Polymerase Chain Reactionen
dc.subject.meshSensitivity and Specificityen
dc.subject.meshStreptococcus pneumoniaeen
dc.titleUtility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults.en
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Iceland, Fac Med, Vatnsmyrarvegi 16, IS-101 Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 2 ] Landspitali Univ Hosp, Dept Med Microbiol & Virol, IS-101 Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 3 ] Univ Gothenburg, Dept Infect Dis Clin Virol, Medicinaregatan 3a-5b, S-40530 Gothenburg, Sweden Show the Organization-Enhanced name(s) [ 4 ] Landspitali Univ Hosp, Div Infect Dis, IS-108 Reykjavik, Icelanden
dc.identifier.journalEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen
dc.rights.accessOpen Access - Opinn aðganguren
refterms.dateFOA2018-09-12T16:29:14Z
html.description.abstractA lack of sensitive tests and difficulties obtaining representative samples contribute to the challenge in identifying etiology in pneumonia. Upper respiratory tract swabs can be easily collected and analyzed with real-time PCR (rtPCR). Common pathogens such as S. pneumoniae and H. influenzae can both colonize and infect the respiratory tract, complicating the interpretation of positive results. Oropharyngeal swabs were collected (n = 239) prospectively from adults admitted to hospital with pneumonia. Analysis with rtPCR targeting S. pneumoniae and H. influenzae was performed and results compared with sputum cultures, blood cultures, and urine antigen testing for S. pneumoniae. Different Ct cutoff values were applied to positive tests to discern colonization from infection. Comparing rtPCR with conventional testing for S. pneumoniae in patients with all tests available (n = 57) resulted in: sensitivity 87 %, specificity 79 %, PPV 59 % and NPV 94 %, and for H. influenzae (n = 67): sensitivity 75 %, specificity 80 %, PPV 45 % and NPV 94 %. When patients with prior antimicrobial exposure were excluded sensitivity improved: 92 % for S. pneumoniae and 80 % for H. influenzae. Receiver operating characteristic curve analysis demonstrated for S. pneumoniae: AUC = 0.65 (95 % CI 0.51-0.80) and for H. influenzae: AUC = 0.86 (95 % CI 0.72-1.00). Analysis of oropharyngeal swabs using rtPCR proved both reasonably sensitive and specific for diagnosing pneumonia caused by S. pneumoniae and H. influenzae. This method may be a useful diagnostic adjunct to other methods and of special value in patients unable to provide representative lower airway samples.


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