Experience of application of the PCR for identification of the causative agent of community acquired pneumonia in the military.

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Summary of "Experience of application of the PCR for identification of the causative agent of community acquired pneumonia in the military."

Samples of sputum, blood, bronchoalveolar lavage, swabs from the oropharynx from 255 military personnel undergoing in-patient treatment with an x-ray confirmed diagnosis of community-acquired pneumonia (CAP) were examined by polymerase chain reaction (PCR). The comparison group was included 270 healthy recruits. The detection of S. pneumoniae, H. influenzaе, M. pneumoniae, C. pneumoniae, C. psittaci, L. pneumophila, Adenovirus, Herpes symplex I/II, Cytomegalovirus was carried out by PCR using AmpliSens commercial test systems (CRIE) and GenPak DNA PCR test (Isogen LLC, Moscow). The etiologic factor of CAP for military personnel is set in 94.1% of cases. S. pneumoniae was the dominant pathogen of CAP. A high level of S. pneumoniae carriage (86.3%) among military personnel was shown. The incidence of M. pneumoniae was 14.5±2.2%, and C. pneumoniae was 13.7±2.2%. The highest detection rates of C. pneumoniae and M. pneumoniae were obtained in patients with not severe CAP - 16.2±2.6% и 16.7±2.7% of cases, respectively. The frequency of detection of these pathogens in patients with severe CAP was significantly lower - 5.3±3.0% and 7.0±3.4%, respectively (p<0.05). The role of L. pneumophila and C. psittaci was negligible. The frequency of detection of adenoviruses was 14,1±2,2% of cases, in particular, in patients with severe CAP - in 36.8±6.4% of cases. A high frequency of bacterial-bacterial and bacterial-viral associations has been established. In etiological CAP diagnostic in military personnel PCR is a highly effective method, especially during periods of high morbidity The high level of S. pneumoniae carriage among military personnel and its dominant role in the etiologic structure of the CAP indicate the need for specific immunization of new recruits. The significant contribution of M. pneumoniae and C. pneumoniae to the incidence of CAP confirm the advisability of their inclusion in the algorithm for the examination of patients with CAP. The high frequency of association of microorganisms indicates the need to take this fact into account when prescribing antibiotic therapy.


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Name: Klinicheskaia laboratornaia diagnostika
ISSN: 0869-2084
Pages: 641-645


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