Evidence map›Paper›PMID 38917227›Full record

Observational studyPloS one2024

Evaluation of a multiplex-qPCR for paediatric pleural empyema-An observational study in hospitalised children.

Jonathan Jacobson, Loraine Fabri, Joshua Osowicki, Shivanthan Shanthikumar, Anna-Maria Costa, Belinda Ortika, Ashleigh Wee-Hee, Michelle Pragassen, Cassandra Gatt, Gena Gonis and 11 more

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Jonathan JacobsonInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.ORCID 0000-0001-8784-7922
Loraine FabriInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Joshua OsowickiInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Shivanthan ShanthikumarInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Anna-Maria CostaDepartment of Microbiology, The Royal Children's Hospital, Parkville, Victoria, Australia.
Belinda OrtikaInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Ashleigh Wee-HeeInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Michelle PragassenComplex Care Hub, The Royal Children's Hospital, Parkville, Victoria, Australia.
Cassandra GattDepartment of Microbiology, The Royal Children's Hospital, Parkville, Victoria, Australia.
Gena GonisDepartment of Microbiology, The Royal Children's Hospital, Parkville, Victoria, Australia.
Cattram NguyenInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Thomas RozenInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Warwick TeagueDepartment of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0003-4747-6025
Jim ButteryInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Vanessa CliffordInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Kim MulhollandInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Andrew SteerInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Sarath RanganathanInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Andrew DaleyDepartment of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
Eileen DunneInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.ORCID 0000-0001-5542-0780
Catherine SatzkeInfection, Immunity and Global Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.ORCID 0000-0003-3164-8849

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pleural empyema is a serious complication of pneumonia in children. Negative bacterial cultures commonly impede optimal antibiotic therapy. To improve bacterial identification, we developed a molecular assay and evaluated its performance compared with bacterial culture. Our multiplex-quantitative PCR to detect Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophilus influenzae was assessed using bacterial genomic DNA and laboratory-prepared samples (n = 267). To evaluate clinical performance, we conducted the Molecular Assessment of Thoracic Empyema (MATE) observational study, enrolling children hospitalised with empyema. Pleural fluids were tested by bacterial culture and multiplex-qPCR, and performance determined using a study gold standard. We determined clinical sensitivity and time-to-organism-identification to assess the potential of the multiplex-qPCR to reduce the duration of empiric untargeted antibiotic therapy. Using spiked samples, the multiplex-qPCR demonstrated 213/215 (99.1%) sensitivity and 52/52 (100%) specificity for all organisms. During May 2019-March 2023, 100 children were enrolled in the MATE study; median age was 3.9 years (IQR 2-5.6). A bacterial pathogen was identified in 90/100 (90%) specimens by multiplex-qPCR, and 24/100 (24%) by bacterial culture (P <0.001). Multiplex-qPCR identified a bacterial cause in 68/76 (90%) culture-negative specimens. S. pneumoniae was the most common pathogen, identified in 67/100 (67%) specimens. We estimate our multiplex-qPCR would have reduced the duration of untargeted antibiotic therapy in 61% of cases by a median 20 days (IQR 17.5-23, range 1-55). Multiplex-qPCR significantly increased pathogen detection compared with culture and may allow for reducing the duration of untargeted antibiotic therapy.

Indexed as

Empyema, PleuralMultiplex Polymerase Chain ReactionAnti-Bacterial AgentsChildChild, PreschoolDNA, BacterialFemaleHaemophilus influenzaeHospitalizationHumansInfantMaleSensitivity and SpecificityStaphylococcus aureusStreptococcus pneumoniaeStreptococcus pyogenesAnti-Bacterial AgentsDNA, Bacterial

Identifiers

PMID38917227
PMCPMC11198775

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.