Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique
Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-c...
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| Veröffentlicht in: | PloS one 2017-09, Vol.12 (9), p.e0184762-e0184762 |
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| creator | Brotons, Pedro Bassat, Quique Lanaspa, Miguel Henares, Desiree Perez-Arguello, Amaresh Madrid, Lola Balcells, Reyes Acacio, Sozinho Andres-Franch, Maria Marcos, Maria Angeles Valero-Rello, Ana Muñoz-Almagro, Carmen |
| description | Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-chain reaction in nasopharyngeal samples to diagnose invasive pneumococcal disease in children.
Matched case-control study of patients |
| doi_str_mv | 10.1371/journal.pone.0184762 |
| format | Article |
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Matched case-control study of patients <5 years of age with invasive pneumococcal disease admitted to the Manhiça District Hospital (Mozambique) and asymptomatic controls recruited in different periods between 2006 and 2014. Cases were confirmed by a positive bacterial culture for S. pneumoniae in blood or cerebrospinal fluid. Nasopharyngeal aspirates were collected from cases and controls and pneumococcal density was quantified by lytA real-time polymerase-chain reaction.
Thirty cases (median age 12.8 months) and sixty controls (median age 11.7 months) were enrolled and 70% of them were male. Nasopharyngeal pneumococcal carriage was high in both groups: 28/30 (93.3%) for cases vs. 53/60 (88.3%) for controls (p = 0.71). Mean nasopharyngeal pneumococcal load was identified as a marker for invasive pneumococcal disease (7.0 log10 copies/mL in cases vs. 5.8 log10 copies/mL in controls, p<0.001) and showed good discriminatory power (AUC-ROC: 82.1%, 95% CI 72.5%-91.8%). A colonization density of 6.5 log10 copies/mL was determined as the optimal cut-off value to distinguish cases from controls (sensitivity 75.0%, specificity 73.6%).
Use of non-invasive nasopharyngeal aspirates coupled with rapid and accurate quantification of pneumococcal load by real-time polymerase chain reaction has the potential to become a useful surrogate marker for early diagnosis of invasive pneumococcal disease in children.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0184762</identifier><identifier>PMID: 28910402</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Analysis ; Antibiotics ; Authorship ; Bacteria ; Bacterial Load ; Bacterial Proteins - genetics ; Biological markers ; Biology and Life Sciences ; Blood ; Case-Control Studies ; Cerebrospinal fluid ; Child, Preschool ; Children ; Colonization ; Control methods ; Diagnosis ; Diagnostic systems ; Disease ; Disease control ; Female ; Health aspects ; HIV ; Hospitals ; Human immunodeficiency virus ; Humans ; Infant ; Infants ; Infeccions per pneumococs ; Malaria ; Male ; Medical diagnosis ; Medicine and Health Sciences ; Methods ; Microbiology ; Mozambique ; Moçambic ; Nasopharyngeal culture ; Nasopharynx - microbiology ; Pediatric diseases ; Pediatrics ; Pneumococcal Infections ; Pneumococcal Infections - diagnosis ; Pneumonia ; Polymerase chain reaction ; Prospective Studies ; Real time ; Real-Time Polymerase Chain Reaction - methods ; Research and Analysis Methods ; Risk factors ; Rural areas ; Sensitivity and Specificity ; Streptococcus infections ; Streptococcus pneumoniae ; Streptococcus pneumoniae - isolation & purification ; Streptococcus pneumoniae - physiology ; Surveillance ; Vaccines ; Viral infections</subject><ispartof>PloS one, 2017-09, Vol.12 (9), p.e0184762-e0184762</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Brotons et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>cc by (c) Brotons et al. , 2017 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</a></rights><rights>2017 Brotons et al 2017 Brotons et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c734t-d2dabd854421b1b883023078b6508600dd7e5e1c6b51d0f0bb43f5015143853d3</citedby><cites>FETCH-LOGICAL-c734t-d2dabd854421b1b883023078b6508600dd7e5e1c6b51d0f0bb43f5015143853d3</cites><orcidid>0000-0001-5586-404X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599037/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599037/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,26974,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28910402$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Melo-Cristino, Jose</contributor><creatorcontrib>Brotons, Pedro</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Lanaspa, Miguel</creatorcontrib><creatorcontrib>Henares, Desiree</creatorcontrib><creatorcontrib>Perez-Arguello, Amaresh</creatorcontrib><creatorcontrib>Madrid, Lola</creatorcontrib><creatorcontrib>Balcells, Reyes</creatorcontrib><creatorcontrib>Acacio, Sozinho</creatorcontrib><creatorcontrib>Andres-Franch, Maria</creatorcontrib><creatorcontrib>Marcos, Maria Angeles</creatorcontrib><creatorcontrib>Valero-Rello, Ana</creatorcontrib><creatorcontrib>Muñoz-Almagro, Carmen</creatorcontrib><title>Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-chain reaction in nasopharyngeal samples to diagnose invasive pneumococcal disease in children.
Matched case-control study of patients <5 years of age with invasive pneumococcal disease admitted to the Manhiça District Hospital (Mozambique) and asymptomatic controls recruited in different periods between 2006 and 2014. Cases were confirmed by a positive bacterial culture for S. pneumoniae in blood or cerebrospinal fluid. Nasopharyngeal aspirates were collected from cases and controls and pneumococcal density was quantified by lytA real-time polymerase-chain reaction.
Thirty cases (median age 12.8 months) and sixty controls (median age 11.7 months) were enrolled and 70% of them were male. Nasopharyngeal pneumococcal carriage was high in both groups: 28/30 (93.3%) for cases vs. 53/60 (88.3%) for controls (p = 0.71). Mean nasopharyngeal pneumococcal load was identified as a marker for invasive pneumococcal disease (7.0 log10 copies/mL in cases vs. 5.8 log10 copies/mL in controls, p<0.001) and showed good discriminatory power (AUC-ROC: 82.1%, 95% CI 72.5%-91.8%). A colonization density of 6.5 log10 copies/mL was determined as the optimal cut-off value to distinguish cases from controls (sensitivity 75.0%, specificity 73.6%).
Use of non-invasive nasopharyngeal aspirates coupled with rapid and accurate quantification of pneumococcal load by real-time polymerase chain reaction has the potential to become a useful surrogate marker for early diagnosis of invasive pneumococcal disease in children.</description><subject>Age</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Authorship</subject><subject>Bacteria</subject><subject>Bacterial Load</subject><subject>Bacterial Proteins - genetics</subject><subject>Biological markers</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Case-Control Studies</subject><subject>Cerebrospinal fluid</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Colonization</subject><subject>Control methods</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease</subject><subject>Disease control</subject><subject>Female</subject><subject>Health aspects</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant</subject><subject>Infants</subject><subject>Infeccions per pneumococs</subject><subject>Malaria</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Microbiology</subject><subject>Mozambique</subject><subject>Moçambic</subject><subject>Nasopharyngeal culture</subject><subject>Nasopharynx - microbiology</subject><subject>Pediatric diseases</subject><subject>Pediatrics</subject><subject>Pneumococcal Infections</subject><subject>Pneumococcal Infections - diagnosis</subject><subject>Pneumonia</subject><subject>Polymerase chain reaction</subject><subject>Prospective Studies</subject><subject>Real time</subject><subject>Real-Time Polymerase Chain Reaction - methods</subject><subject>Research and Analysis Methods</subject><subject>Risk factors</subject><subject>Rural areas</subject><subject>Sensitivity and Specificity</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Streptococcus pneumoniae - isolation & purification</subject><subject>Streptococcus pneumoniae - physiology</subject><subject>Surveillance</subject><subject>Vaccines</subject><subject>Viral 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Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brotons, Pedro</au><au>Bassat, Quique</au><au>Lanaspa, Miguel</au><au>Henares, Desiree</au><au>Perez-Arguello, Amaresh</au><au>Madrid, Lola</au><au>Balcells, Reyes</au><au>Acacio, Sozinho</au><au>Andres-Franch, Maria</au><au>Marcos, Maria Angeles</au><au>Valero-Rello, Ana</au><au>Muñoz-Almagro, Carmen</au><au>Melo-Cristino, Jose</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-09-14</date><risdate>2017</risdate><volume>12</volume><issue>9</issue><spage>e0184762</spage><epage>e0184762</epage><pages>e0184762-e0184762</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-chain reaction in nasopharyngeal samples to diagnose invasive pneumococcal disease in children.
Matched case-control study of patients <5 years of age with invasive pneumococcal disease admitted to the Manhiça District Hospital (Mozambique) and asymptomatic controls recruited in different periods between 2006 and 2014. Cases were confirmed by a positive bacterial culture for S. pneumoniae in blood or cerebrospinal fluid. Nasopharyngeal aspirates were collected from cases and controls and pneumococcal density was quantified by lytA real-time polymerase-chain reaction.
Thirty cases (median age 12.8 months) and sixty controls (median age 11.7 months) were enrolled and 70% of them were male. Nasopharyngeal pneumococcal carriage was high in both groups: 28/30 (93.3%) for cases vs. 53/60 (88.3%) for controls (p = 0.71). Mean nasopharyngeal pneumococcal load was identified as a marker for invasive pneumococcal disease (7.0 log10 copies/mL in cases vs. 5.8 log10 copies/mL in controls, p<0.001) and showed good discriminatory power (AUC-ROC: 82.1%, 95% CI 72.5%-91.8%). A colonization density of 6.5 log10 copies/mL was determined as the optimal cut-off value to distinguish cases from controls (sensitivity 75.0%, specificity 73.6%).
Use of non-invasive nasopharyngeal aspirates coupled with rapid and accurate quantification of pneumococcal load by real-time polymerase chain reaction has the potential to become a useful surrogate marker for early diagnosis of invasive pneumococcal disease in children.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28910402</pmid><doi>10.1371/journal.pone.0184762</doi><tpages>e0184762</tpages><orcidid>https://orcid.org/0000-0001-5586-404X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-09, Vol.12 (9), p.e0184762-e0184762 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1938935533 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); Recercat; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Analysis Antibiotics Authorship Bacteria Bacterial Load Bacterial Proteins - genetics Biological markers Biology and Life Sciences Blood Case-Control Studies Cerebrospinal fluid Child, Preschool Children Colonization Control methods Diagnosis Diagnostic systems Disease Disease control Female Health aspects HIV Hospitals Human immunodeficiency virus Humans Infant Infants Infeccions per pneumococs Malaria Male Medical diagnosis Medicine and Health Sciences Methods Microbiology Mozambique Moçambic Nasopharyngeal culture Nasopharynx - microbiology Pediatric diseases Pediatrics Pneumococcal Infections Pneumococcal Infections - diagnosis Pneumonia Polymerase chain reaction Prospective Studies Real time Real-Time Polymerase Chain Reaction - methods Research and Analysis Methods Risk factors Rural areas Sensitivity and Specificity Streptococcus infections Streptococcus pneumoniae Streptococcus pneumoniae - isolation & purification Streptococcus pneumoniae - physiology Surveillance Vaccines Viral infections |
| title | Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique |
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