A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Clinical Microbiology and Infectious Diseases. Johannesburg, 2013 / Introduction
To determine the spectrum of aetiological agents in adult Community Acquired
Pneumonia (CAP) admitted to an academic hospital in Johannesburg using a novel
transport medium (PrimeStore™ MTM), in addition to traditional specimen
processing. PrimeStore™ MTM preserves released nucleic acids, including labile
RNA.
Materials and Methods
Forty-eight adult patients with radiologically confirmed CAP were prospectively
studied over three months. Microbiological investigation included culture from blood
and sputum, with pulmonary tuberculosis being excluded by sputum microscopy and
culture. Nasopharyngeal swabs (PrimeStore™ MTM) were analysed using two
commercial multiplex PCR assays for the detection of 6 major bacteria and 12 major
respiratory viruses. The BinaxNOW Legionella urinary antigen test was also used.
Results
A probable microbial aetiology of CAP was established for 62.5% (30 of the 48
patients) when the PCR platform was added to the conventional methods with the
use of the PrimeStore™ MTM swabs. In contrast, the definite bacterial aetiology
was 16.7% (8 of 48 patients) when conventional culture methods were used; none
had more than one bacterial species identified. Five patients had no aetiological
pathogens determined. The urine Legionella pneumophila antigen was negative in
all patients. Of the eight patients (16.7%) with a definite bacterial aetiology;
Streptococcus pneumoniae was isolated from blood cultures of all eight patients.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17362 |
| Date | 27 March 2015 |
| Creators | Meiday, Parastu |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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