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Volume 46, Number 6, December 2013

Comparison of diagnostic tools with multiplex polymerase chain reaction for pediatric lower respiratory tract infection: A single center study 


Yu-Shen Chen, Po-Yen Liu, Yung-Feng Huang, Chiao-Shan Chen, Ling-Hui Chiu, Nuan-Ya Huang, Kai-Sheng Hsieh, Yao-Shen Chen


Received: April 30, 2012    Revised: July 2, 2012    Accepted: July 26, 2012   

 

Corresponding author:

Yung-Feng Huang
Department of Pediatrics, Kaohsiung Veterans General Hospital, Taiwan, ROC
Corresponding Author InformationCorresponding author. Department of Pediatrics, Kaohsiung Veterans General Hospital, 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 813, Taiwan, ROC. 



 

Background and purpose: 

Acute respiratory tract infections are a leading cause of morbidity and mortality in children worldwide. Most have a viral etiology, with pneumococcus as an important pathogen. This single-center study compared the use of conventional diagnostic tools and two multiplex polymerase chain reaction (PCR) examinations for determining pathogens in lower respiratory tract infections (LRTIs) among children aged <5 years. 



 

Methods:

From July to October 2010, 45 patients aged 2 months to 60 months and diagnosed as having LRTIs were enrolled. Their nasopharyngeal aspirates were evaluated through viral culture and two multiplex PCR examinations. The patients' clinical course, symptoms, signs, and laboratory findings were recorded and analyzed. 



 

Results:

Among the 45 patients, 38 (84.4%) had detectable pathogens. Conventional viral and blood cultures had 35.6% positive rate, which increased to 51.1% when the quick antigen tests (Influenza A+B test and respiratory syncytial virus) and urine pneumococcal antigen test were combined. The positive rate further increased to 84.4% when the two multiplex PCR methods were combined. Twelve patients had co-infection, including 10 detected by the multiplex PCR methods. The co-infection rate was 26.7% (12/45). 



 

Conclusion:

Most LRTIs in children have a viral etiology. Multiplex PCR tests are rapid assays that can increase the diagnostic yield rate and detect slow-growing viruses and can detect more pathogens than conventional viral culture to enable, thereby helping clinicians to provide appropriate and timely treatment. 



 

Key words:

Lower respiratory tract infection, Multiplex polymerase chain reaction, Virus