RT Journal Article
SR Electronic
T1 Usefulness of multiplex real-time polymerase chain reaction for diagnosing community acquired pneumonia in Japanese adults
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2692
VO 42
IS Suppl 57
A1 Yutaka Yoshii
A1 Kenichiro Shimizu
A1 Miyuki Morozumi
A1 Nahoko Chiba
A1 Kimiko Ubukata
A1 Makoto Kawaishi
A1 Keisuke Saito
A1 Jun Araya
A1 Katsutoshi Nakyama
A1 Kazuyoshi Kuwano
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2692.abstract
AB Background: Usefulness of multiplex real-time polymerase chain reaction (RT-PCR) and frequency of macrolide-resistant (MR) Mycoplasma pneumoniae (M. p) in Japanese adults are unknown. Aims: To diagnose causative pathogens of community acquired pneumonia (CAP) in Japanese adults with RT-PCR vs. conventional tests (sputum/blood culture, urine antigen for Streptococcus pneumoniae [S. p]/Legionella pneumophila [L. p], and paired serum of M. p antibody) and clarify frequency of MR M. p in Japanese adults. Methods: We prospectively enrolled 29 CAP patients ≥20 years old from Sep 2012 to Feb 2013. CAP was defined based on respiratory symptoms and laboratory/chest X-ray findings excluding noninfectious causes. We collected sputum, nasopharyngeal swab, urine, and blood samples of each patient. RT-PCR can identify 6 bacteria and 11 viruses in sputum and nasopharyngeal swab samples. Causative pathogens were identified by each test. MR gene was checked if PCR of M. p was positive. Results: Mean patient age (15 men) was 56 years, and 20 had taken previous antibiotics. Sensitivity was significantly higher in RT-PCR vs. conventional tests (69%, n=20 vs. 41%, n=12; P<0.05). Common causative pathogens by RT-PCR were S. p (n=10), M. p (n=7) and Haemophilus influenzae (n=4), including duplication, with 4 cases of mixed bacterial/viral infection. Four (57%) of 7 M.p patients were MR by RT-PCR. Conclusions: Since many patients had taken previous treatment, sensitivity of conventional tests was low, but RT-PCR was unaffected by this. RT-PCR was useful for CAP in Japanese adults. When M. p is suspected, RT-PCR is especially useful because sensitivity is high and MR can be checked.