Molecular Analysis Improves Pathogen Identification and Epidemiologic Study of Pediatric Parapneumonic Empyema

• DOI: 10.1097/inf.0b013e3182002d14
• Publication Date: 2010-11-06T06:18:24Z
• Authors: Anne J. Blaschke; Caroline Heyrend; Carrie L. Byington; Ignacio Obando; Isabel Vazquez-Barba; Elizabeth H. Doby; E. Kent Korgenski; Xiaoming Sheng; Mark A. Poritz; Judy A. Daly; Edward O. Mason; Andrew T. Pavia; Krow Ampofo
• Keywords: Streptococcus Pyogenes; Pleural empyema; Microbiological culture

Parapneumonic empyema (PPE) is an increasingly common complication of bacterial pneumonia. Epidemiologic study complicated by the low frequency positive cultures. We sought to describe epidemiology PPE in children using molecular analysis pleural fluid.We performed testing for pathogens archived fluid from hospitalized 2009 with PPE. Real-time polymerase chain reaction (PCR) detect Streptococcus pneumoniae, Staphylococcus aureus (including methicillin-resistant), pyogenes, Haemophilus influenzae, and Mycoplasma pneumoniae as well PCR-based serotyping S. was performed. Demographic, laboratory, microbiologic data were abstracted.Pleural specimens 63 available PCR. By culture, a pathogen isolated blood and/or 22 (35%) patients, 15 (24%), pyogenes 3 (5%), methicillin-resistant 4 (6%). PCR, detected 53 (84%), including 45 (71%). Compared PCR significantly increased detection any (35% vs. 84%; P < 0.001) (24% 71%; 0.001). Serotype 7F most pneumococcal serotype detected. Comparison culture-negative culture-positive disease showed differences both profile clinical outcomes.Molecular more than doubled causing cause PPE, although distribution outcomes differed.