Abstract
BackgroundRespiratory tract infection (RTI) in young children is a leading cause of morbidity and hospitalization worldwide. There are few studies assessing the performance for bronchoalveolar lavage fluid (BALF) versus oropharyngeal swab (OPS) specimens in microbiological findings for children with RTI. The primary purpose of this study was to compare the detection rates of OPS and paired BALF in detecting key respiratory pathogens using suspension microarray.MethodsWe collected paired OPS and BALF specimens from 76 hospitalized children with respiratory illness. The samples were tested simultaneously for 8 respiratory viruses and 5 bacteria by suspension microarray.ResultsOf 76 paired specimens, 62 patients (81.6%) had at least one pathogen. BALF and OPS identified respiratory pathogen infections in 57 (75%) and 49 (64.5%) patients, respectively (P > 0.05). The etiology analysis revealed that viruses were responsible for 53.7% of the patients, whereas bacteria accounted for 32.9% and Mycoplasma pneumoniae for 13.4%. The leading 5 pathogens identified were respiratory syncytial virus, Streptococcus pneumoniaee, Haemophilus influenzae, Mycoplasma pneumoniae and adenovirus, and they accounted for 74.2% of etiological fraction. For detection of any pathogen, the overall detection rate of BALF (81%) was marginally higher than that (69%) of OPS (p = 0.046). The differences in the frequency distribution and sensitivity for most pathogens detected by two sampling methods were not statistically significant.ConclusionsIn this study, BALF and OPS had similar microbiological yields. Our results indicated the clinical value of OPS testing in pediatric patients with respiratory illness.
Highlights
Respiratory tract infection (RTI) in young children is a leading cause of morbidity and hospitalization worldwide
Clinical information of included subjects A total of 76 young children were subjected to respiratory pathogens detection in this project
According to the 2013 WHO definition of severe pneumonia and guideline for children with community acquired pneumonia in China (2013 version), 22 patients were considered as severe respiratory tract infection (SRTI) and admitted to Pediatric intensive care unit (PICU) with clinical
Summary
Respiratory tract infection (RTI) in young children is a leading cause of morbidity and hospitalization worldwide. The primary purpose of this study was to compare the detection rates of OPS and paired BALF in detecting key respiratory pathogens using suspension microarray. Respiratory tract infection (RTI) in children is a leading cause of morbidity and hospitalization [1, 2]. Accurate and rapid identification of the etiologic agents has an essential role in ensuring the appropriate and effective treatment for patients with respiratory illness, which could avoid unnecessary usage of antibiotics, reduce the overall costs and shorten the period of hospitalization [4]. Laboratory diagnosis of respiratory infections is performed traditionally using culture and immunological assays. Suspension microarray enables simultaneously detect a number of pathogens in a single assay, it has faster hybridization kinetics and more flexibility in array construction compared to traditional solid-phase array
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