期刊
JOURNAL OF CLINICAL MICROBIOLOGY
卷 55, 期 1, 页码 110-121出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.01805-16
关键词
community-acquired pneumonia; pneumonia; multipathogen; diagnostics; TaqMan array card; NP/OP; TAC; sputum
类别
资金
- NHLBI NIH HHS [P01 HL071643] Funding Source: Medline
- NIGMS NIH HHS [K23 GM110469] Funding Source: Medline
New diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (<18 years old) and adults hospitalized with CAP were enrolled over 2.5 years through the Etiology of Pneumonia in the Community (EPIC) study. NP/OP specimens with matching high-quality sputum (defined as <= 10 epithelial cells/low-power field [lpf] and >= 25 white blood cells/lpf or a quality score [q-score] definition of 2+) were tested by TaqMan array card (TAC), a multipathogen real-time PCR detection platform. Among 236 patients with matched specimens, a higher proportion of sputum specimens had >= 1 pathogen detected compared with NP/OP specimens in children (93% versus 68%; P < 0.0001) and adults (88% versus 61%; P < 0.0001); for each pathogen targeted, crossing threshold (C-T) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.
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