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Detection of respiratory viruses and Legionella spp. by real-time polymerase chain reaction in patients with community acquired pneumonia 

Authors: Bram M. W. Diederena; Menno M. Van Der Eerdenb; Fer Vlaspolderc; Wim G. Boersmad; Jan A. J. W. Kluytmansef; Marcel F. Peetersg
Affiliations:   a From the Regional Laboratory of Public Health Haarlem, Haarlem
b Department of Pulmonary Medicine, Erasmus Medical Centre, Rotterdam
c Laboratory for Medical Microbiology, Medical Centre Alkmaar, Alkmaar
d Department of Pulmonary Diseases, Medical Centre Alkmaar, Alkmaar
e Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda
f Department of Medical Microbiology and Infection Control, Free University Medical Centre, Amsterdam
g Laboratory for Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilburg, The Netherlands
DOI: 10.1080/00365540802448799
Publication Frequency: 10 issues per year
Published in: journal Scandinavian Journal of Infectious Diseases, Volume 41, Issue 1 2009 , pages 45 - 50
First Published: 2009
Formats available: HTML (English) : PDF (English)
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Abstract

We conducted a study on throat swabs obtained from a group of hospitalized patients with community acquired pneumonia (CAP). Throat swab specimens from 242 adults admitted to hospital with CAP were tested. In total, 1 or more aetiological agents were identified by real-time PCR in 55 (23%) patients. The most frequently detected pathogens were coronavirus (17%), parainfluenza virus (6%) and influenza virus (4%). Overall, viral pathogens were identified by conventional techniques in 7 (2%) patients, and real-time PCR in 50 (21%) patients (p<0.0001). The diagnostic yield increased from 137 cases (57% of patients using conventional microbiological assays) to 158 cases (65% of patients using real-time PCR assays and conventional microbiological assays; p=0.06). A significantly higher percentage of mortality was present in patients with a mixed bacterial and viral infection. L. pneumophila PCR was positive in only 3 out of 11 cases (27%) of Legionnaires' disease (LD). This study demonstrates that real-time PCR can increase the number of microbiological detections of respiratory pathogens, mainly as a result of detection of respiratory viruses.
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