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Войти в исследования Colonization Density of the Upper Respiratory Tract as a Predictor of Pneumonia-Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii.
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Park Daniel E, Baggett Henry C, Howie Stephen R C, Shi Qiyuan, Watson Nora L, Brooks W Abdullah, Deloria Knoll Maria, Hammitt Laura L, Kotloff Karen L, Levine Orin S, Madhi Shabir A, Murdoch David R, O'Brien Katherine L, Scott J Anthony G, Thea Donald M, Ahmed Dilruba, Antonio Martin, Baillie Vicky L, DeLuca Andrea N, Driscoll Amanda J, Fu Wei, Gitahi Caroline W, Olutunde Emmanuel, Higdon Melissa M, Hossain Lokman, Karron Ruth A, Maiga Abdoul Aziz, Maloney Susan A, Moore David P, Morpeth Susan C, Mwaba John, Mwenechanya Musaku, Prosperi Christine, Sylla Mamadou, Thamthitiwat Somsak, Zeger Scott L, Feikin Daniel R, PERCH Study Group
Аннотация
METHODS.: In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR). Differences in median colonization density were evaluated using the Wilcoxon rank-sum test. Density cutoffs were determined using receiver operating characteristic curves. Cases with a pathogen identified from lung aspirate culture or PCR, pleural fluid culture or PCR, blood culture, and immunofluorescence for P. jirovecii defined microbiologically confirmed cases for the given pathogens.
RESULTS.: Higher densities of H. influenzae were observed in both microbiologically confirmed cases and chest radiograph (CXR)-positive cases compared to controls. Staphylococcus aureus and P. jirovecii had higher densities in CXR-positive cases vs controls. A 5.9 log10 copies/mL density cutoff for H. influenzae yielded 86% sensitivity and 77% specificity for detecting microbiologically confirmed cases; however, densities overlapped between cases and controls and positive predictive values were poor (<3%). Informative density cutoffs were not found for S. aureus and M. catarrhalis, and a lack of confirmed case data limited the cutoff identification for P. jirovecii.
CONCLUSIONS.: There is evidence for an association between H. influenzae colonization density and H. influenzae-confirmed pneumonia in children; the association may be particularly informative in epidemiologic studies. Colonization densities of M. catarrhalis, S. aureus, and P. jirovecii are unlikely to be of diagnostic value in clinical settings.