用聚合酶链反应诊断儿童肺炎时的胸腔积液  

Diagnosis of parapneumonic pleural effusion by polymerase chain reaction in children

作　　者：Menezes-Martins L.F. Menezes-Martins J.J. Mich-aelsen V.S. D.C. Machado 王经纬 

机构地区：[1]Instituto de Pes-quisas Biomé dicas, Pontifcia Universidade Cató lica Do Rio Grande Do Sul, Rio Grande do Sul, 90.610- 000, Brazil

出　　处：《世界核心医学期刊文摘（儿科学分册）》2005年第12期51-51,共1页

摘　　要：Most pleural effusions are associated with bacterial pneumonia, and the identification of the pathogen will assist the therapeutic decision. A specific method that is not affected by previous antibiotic therapy is sought to detect the main causative agents of pneumonia in infants and children (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus). The aim of the present study was to compare the polymerase chain reaction (PCR) technique with standard culture methods in identifying bacterial infections in infants’ and children’s pleural effusion. Methods: Samples obtained from pediatric patients (n = 37) with a diagnosis of pneumonia associated to pleural effusion, submitted to thoracentesis, were analyzed by PCR with specific primers. Results: The PCR technique identified the presence of bacterial infection in a larger proportion (95.2% ) than the standard culture method (33.3% ) on complicated pleural effusion samples. The microorganism detection on uncomplicated pleural effusion samples was positive only by the PCR method (31.3% ). The frequencies of microorganisms identified on complicated pleural effusion were 57.1% of all patients for methicillin-resistant Staphylococcus; 52.4% , S pneumoniae; 28.6% , S aureus; and 23.8% , H influenzae. The previous use of antibiotics interferes with standard culture method, but it did not interfere with the PCR results. Conclusions: The molecular diagnosis by PCR method could improve the etiologic diagnosis and might help to guide the treatment of parapneumonic effusion in children.Most pleural effusions are associated with bacterial pneumonia, and the identification of the pathogen will assist the therapeutic decision. A specific method that is not affected by previous antibiotic therapy is sought to detect the main causative agents of pneumonia in infants and children (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus). The aim of the present study was to compare the polymerase chain reaction (PCR) technique with standard culture methods in identifying bacterial infections in infants' and children's pleural effusion. Methods: Samples obtained from pediatric patients (n = 37) with a diagnosis of pneumonia associated to pleural effusion, submitted to thoracentesis, were analyzed by PCR with specific primers. Results: The PCR technique identified the presence of bacterial infection in a larger proportion (95.2% ) than the standard culture method (33.3% ) on complicated pleural effusion samples. The microorganism detection on uncomplicated pleural effusion samples was positive only by the PCR method (31.3% ). The frequencies of microorganisms identified on complicated pleural effusion were 57.1% of all patients for methicillin-resistant Staphylococcus; 52.4% , S pneumoniae; 28.6% , S aureus; and 23.8% , H influenzae. The previous use of antibiotics interferes with standard culture method, but it did not interfere with the PCR results. Conclusions: The molecular diagnosis by PCR method could improve the etiologic diagnosis and might help to guide the treatment of parapneumonic effusion in children.

关 键 词：儿童肺炎 聚合酶链反应 胸腔积液 流感嗜血杆菌 细菌性肺炎 金黄色葡萄球菌 细菌感染 肺炎链球菌 甲氧苯青霉素 胸腔穿刺 

分 类 号：R725.6[医药卫生—儿科]