Multiplex PCR for Pathogen Identification among Otherwise Healthy Children Presenting with AcuteLife-threatening Infection

Authors

  • Warunee Punpanich Vandepitte, M.D. สถาบันสุขภาพเด็กแห่งชาติมหาราชินี
  • Ruangruthai Chimsang, M.D. สถาบันวิจัยวิทยาศาสตร์การแพทย์ทหาร
  • Chonticha Klungthong, D.S. สถาบันวิจัยวิทยาศาสตร์การแพทย์ทหาร
  • Stefan Fernandez, D.S. คณะแพทยศาสตร์ มหาวิทยาลัยรังสิต

Keywords:

Sepsis, Septic shock, Pneumonia, Respiratory failure, Multiplex polymerase chain reaction

Abstract

Background : Diagnostic yield of conventional, culture-based method of pathogen detection among sepsis and severe pneumonia is generally disappointedly low.

Objectives : To determine the etiological organisms causing community-acquired life-threatening infections (CA-LTI) among previously healthy children using multiplex polymerase chain reaction (mPCR).

Methods : A prospective descriptive survey was conducted among all children aged 1 month -15 years diagnosed with community-acquired sepsis with septic shock and pneumonia with respiratory failure. Serum and/or tracheal aspirates for pathogen identification using mPCR targeting 33 common pathogens were obtained from all subjects.

Results : A total of 79 cases were enrolled: n = 17 for sepsis (21.5%) and n = 62 for pneumonia (78.5%). Nine cases (11.4%) had one pathogen identified in serum sample using mPCR: n = 4 (23.5%) for sepsis and n=5 (8%) for pneumonia cases. Among sepsis cases, the pathogens identified in serum via mPCR were rhinovirus and bocavirus, (n=2 each). One pathogen identified by conventional blood culture was Entercoccus faecalis. Among pneumonia cases, 8% (n=5) had at least one potential pathogen identified in serum by mPCR with bocavirus and H. influenzae being the most common (n= 2 each). Similarly, H. influenzae were the most commonly identified by mPCR in tracheal aspirates (n=10). The fatality rates were 5.9% among sepsis and 1.6% among pneumonia cases.

Conclusions : Viruses are among the important causes of CA-LTI in previously healthy children. Using mPCR enables 9-fold increase in the proportion of pathogen identification in serum in children with septic shock and severe pneumonia.

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Published

18-06-2021

How to Cite

1.
Punpanich ว, Chimsang ร, Klungthong ช, Fernandez ส. Multiplex PCR for Pathogen Identification among Otherwise Healthy Children Presenting with AcuteLife-threatening Infection. j dept med ser [Internet]. 2021 Jun. 18 [cited 2022 Aug. 14];46(1):202-11. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/251855

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Original Article