Abstract | STUDY OBJECTIVE: Streptococcus pneumoniae is the most frequent causative agent of community-acquired pneumonia (CAP); however, an etiologic diagnosis by traditional techniques can be accomplished in only a small percentage of patients with CAP. Pleural fluid is present in approximately 40% of patients with CAP; therefore, we hypothesized that detection of S pneumoniae DNA in pleural fluid by polymerase chain reaction (PCR) may help to increase the rate of diagnosis of pneumococcal pneumonia. DESIGN: A prospective study of cases. SETTING: A university hospital in Lleida, Spain. PATIENTS AND METHODS: One hundred two samples of pleural fluid (51 samples from consecutive adult patients with pneumonia and 51 samples from unselected control subjects) were tested by the nested-PCR method to detect selected pneumolysin gene of S pneumoniae, and the results were compared with those provided by alternative diagnostic methods. RESULTS: PCR in pleural fluid had a diagnostic sensitivity of 78% in patients with pneumococcal pneumonia, with positive results in 2 of 2 patients (100%) and 5 of 7 patients (71%) who had positive or negative pleural fluid culture findings, respectively. PCR results were also positive in 3 of 24 patients (12%) with pneumonia of unknown etiology and negative in all patients with pneumonia due to microorganisms other than S pneumoniae. Thus, the calculated specificity was 93%. Among control subjects, PCR gave positive results in two cases (4%). CONCLUSION: The nested-PCR test, applied to pleural fluid samples from patients with CAP, showed a sensitivity of 78% and a specificity of 93% in the diagnosis of pneumococcal pneumonia.
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Authors | Miquel Falguera, Aurora López, Antoni Nogués, José Manuel Porcel, Manuel Rubio-Caballero |
Journal | Chest
(Chest)
Vol. 122
Issue 6
Pg. 2212-6
(Dec 2002)
ISSN: 0012-3692 [Print] United States |
PMID | 12475865
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Community-Acquired Infections
(microbiology)
- DNA, Bacterial
(analysis)
- Female
- Humans
- Male
- Middle Aged
- Pleural Effusion
(chemistry)
- Pneumonia, Bacterial
(microbiology)
- Polymerase Chain Reaction
- Prospective Studies
- Sensitivity and Specificity
- Streptococcus pneumoniae
(genetics)
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