Application of nested multiplex polymerase chain reaction respiratory and pneumonia panels in children with severe community-acquired pneumonia.

Content Provider	Europe PMC
Author	Yen, Ting‐Yu Chen, Jian‐Fu Lu, Chun‐Yi Wu, En‐Ting Wang, Ching‐Chia Lu, Frank Leigh Huang, Li‐Min Chang, Luan‐Yin
Abstract	Community‐acquired pneumonia (CAP) is a serious clinical concern. A lack of accurate diagnosis could hinder pathogen‐directed therapeutic strategies. To solve this problem, we evaluated clinical application of nested multiplex polymerase chain reaction (PCR) in children with severe CAP. We prospectively enrolled 60 children with severe CAP requiring intensive care between December 2019 and November 2021 at a tertiary medical center. Nested multiplex PCR respiratory panel (RP) and pneumonia panel (PP) were performed on upper and lower respiratory tract specimens. We integrated standard‐of‐care tests and quantitative PCR for validation. The combination of RP, PP, and standard‐of‐care tests could detect at least one pathogen in 98% of cases and the mixed viral‐bacterial detection rate was 65%. The positive percent agreement (PPA), and negative percent agreement (NPA) for RP were 94% and 99%; the PPA and NPA for PP were 89% and 98%. The distribution of pathogens was similar in the upper and lower respiratory tracts, and the DNA or RNA copies of pathogens in the lower respiratory tract were equal to or higher than those in the upper respiratory tract. PP detected bacterial pathogens in 40 (67%) cases, and clinicians tended to increase bacterial diagnosis and escalate antimicrobial therapy for them. RP and PP had satisfactory performance to help pediatricians make pathogenic diagnoses and establish therapy earlier. The pathogens in the upper respiratory tract had predictive diagnostic values for lower respiratory tract infections in children with severe CAP.
Page Count	8
ISSN	01466615
Journal	Journal of Medical Virology
Volume Number	95
PubMed Central reference number	PMC10108056
Issue Number	1
PubMed reference number	36418155
e-ISSN	10969071
DOI	10.1002/jmv.28334
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2023-01-01
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.
Subject Keyword	children community acquired infection intensive care units nested multiplex PCR pneumonia
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Virology