{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:19:23Z","timestamp":1753877963629,"version":"3.41.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,6]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The etiological diagnosis of community-acquired pneumonia (CAP) is still a challenge. We compared the conventional culture method and real-time polymerase chain reaction (RT-PCR) for the identification of Streptococcus pneumoniae in severe pediatric CAP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective hospital-based study was conducted. From 2012 to 2018, we have selected patients who had peripheral blood and\/or pleural fluid collected for etiological investigation by RT-PCR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 113 children (median age: 3\u2009years; interquartile range 1\u20136\u2009years). RT-PCR increased the detection rate of S. pneumoniae by 6.5 times using blood samples and eight times using pleural fluid samples. Patients subjected to RT-PCR showed more prolonged hospitalization (p\u2009=\u20090.006), fewer comorbidities (p\u2009=\u20090.03), presence of pleural effusion (p\u2009=\u20090.001), presence of young forms of leukocytes (p\u2009=\u20090.001) and radiograph with characteristics of pneumonia (p\u2009=\u20090.002). The presence of pleural effusion [odds ratio (OR)\u2009=\u200914.7, 95% confidence interval (CI) 1.6\u2013133.9; p\u2009=\u20090.01] and young forms of leukocytes (OR\u2009=\u20098.9, 95% CI 0.9\u201384.4; p\u2009=\u20090.05) were risk factors for positive RT-PCR pneumococcal when multivariate analysis was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>RT-PCR is a reliable method for diagnosing severe CAP using sterile materials and a potentially applicable method in patients with clinical, radiological and non-specific laboratory characteristics of lower respiratory tract infection, especially in complicated cases with pleural effusion.<\/jats:p>\n               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Zembruski","family":"Nunes","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Santa Casa de S\u00e3o Paulo , S\u00e3o Paulo 01221-010, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela Marinho","family":"Tridente","sequence":"additional","affiliation":[{"name":"Department of Radiology, Santa Casa de S\u00e3o Paulo , S\u00e3o Paulo 01221-010, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana Amorim Teixeira","family":"Grill","sequence":"additional","affiliation":[{"name":"Department of Radiology, Santa Casa de S\u00e3o Paulo , S\u00e3o Paulo 01221-010, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eitan Naaman","family":"Berezin","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Santa Casa de S\u00e3o Paulo , S\u00e3o Paulo 01221-010, 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