Background PCR technologyholds promise to overcome the limitations of bacterial culture for confirming bacterial aetiology in childhood pneumonia.
Aims To compare the diagnostic yield using bacterial culture versus PCR in a cohort of children with community acquired pneumonia (CAP).
Methods CAPES is single-centre cohort study of 2000 consecutively enrolled children (1 month-12 years) with CAP(World Health Organisation definition). All underwent blood and nasopharyngeal aspirate (NPA) culture for bacteria. In addition, a randomly selected sub-group (10%,n = 200) underwent multiplex PCR on NPA samples to identify eight pathogenic bacteria.
Results In the sub-cohort of 200 children, pathogenic organisms were isolated from blood and NPA in 4(2%) and 30(15%) respectively (Figure 1). The main cohort showed similar proportions (1.7% and 14.0%) and distribution of organisms, suggesting absence of selection bias. Multiplex PCR(Figure 2) yielded traces of bacteria in 193(96.5%),with one organism detected in 44(22%), two in 76(38%), three in 53(26.5%), and four in 20(10%). Etiologic diagnosis could be confirmed by bacterial culture in4.5% cases, whereas PCR confirmed in 22%.