ArticleJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy2007
Rapid optimization of antimicrobial chemotherapy given to pediatric patients with community-acquired pneumonia using PCR techniques with serology and standard culture.
Article in Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Incidence of viral infection detected by PCR and real-time PCR in childhood community-acquired pneumonia: a meta-analysis.Respirology (Carlton, Vic.) · 2015Pooled it
- Clinical symptoms and signs for the diagnosis of Mycoplasma pneumoniae in children and adolescents with community-acquired pneumonia.The Cochrane database of systematic reviews · 2012Pooled it
- Minocycline as A Substitute for Doxycycline in Targeted Scenarios: A Systematic Review.Open forum infectious diseases · 2015Review
- Effects of bacterial and viral co-infections of mycoplasma pneumoniae pneumonia in children: analysis report from Beijing Children's Hospital between 2010 and 2014.International journal of clinical and experimental medicine · 2015Article
- Limited utility of culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae for diagnosis of respiratory tract infections.Journal of clinical microbiology · 2010Article
- Investigation of pneumonia-causing pathogenic organisms in children and the usefulness of tebipenem pivoxil for their treatment.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2010Article
- Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines.European journal of pediatrics · 2009Article
- Comprehensive detection of causative pathogens using real-time PCR to diagnose pediatric community-acquired pneumonia.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2008Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Children (n = 117; mean age 2.4 +/- 2.9 years) were diagnosed as having community-acquired pneumonia (CAP) using clinical symptoms, chest X-rays, and hematological data. The causative pathogen was determined using real-time polymerase chain reaction (PCR) (6 bacteria), multiple reverse transcription-PCR (MPCR; 11 viruses), bacterial culture, and serology. The initial chemotherapy was evaluated based on the pathogens identified using PCR. We found 27 viral cases (23.1%), 25 bacterial cases (21.4%), 45 mixed infections with virus and bacteria (38.5%), 10 Mycoplasma pneumoniae (8.5%), 7 mixed infections with M. pneumoniae and another pathogen (6.0%), 1 Chlamydophila pneumoniae (0.9%), and 2 unknown pathogens (1.7%). Streptococcus pneumoniae and Haemophilus influenzae accounted for 58 (49.5%) and 27 (23.0%) of the cases, respectively. The median values (50%) of the white blood cell count (WBC) and C-reactive protein (CRP) using the box-and-whisker and plot method, respectively, were 11.7 x 10(3) mm(-3) and 1.4 mg/dl in viral infections, 15.6 x 10(3) mm(-3) and 4.8 mg/dl in mixed infections with virus and bacteria, 17.8 x 10(3) mm(-3) and 6.3 mg/dl in bacterial infections, 6.7 x 10(3) mm(-3) and 1.4 mg/dl in M. pneumoniae infections, and 21.5 x 10(3) mm(-3) and 6.4 mg/dl in mixed infections with M. pneumoniae and other bacterial infections. Sulbactam/ampicillin (n = 61), carbapenems (n = 12), and ceftriaxone (n = 7) were selected for the patients suspected of having bacterial infections alone or mixed infections with bacterial and viruses in accordance with our criteria defined tentatively. For those with M. pneumoniae and C. pneumoniae infections, azithromycin or minocycline was initially used. Treatments averaged 3-5 days. The empirical chemotherapy was improper in 9.4% of cases in relation to the etiologic agents finally identified. We conclude that rapid and comprehensive identification using PCR can provide optimal antimicrobial chemotherapy for CAP patients.
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