Improved detection of respiratory pathogens by use of high-quality sputum with TaqMan array card technology

Bernard J. Wolff, Anna M. Bramley, Kathleen A. Thurman, Cynthia G. Whitney, Brett Whitaker, Wesley H. Self, Sandra R. Arnold, Christopher Trabue, Richard G. Wunderink, Jon McCullers, Kathryn M. Edwards, Seema Jain, Jonas M. Winchell*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

New diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (<18 years old) and adults hospitalized with CAP were enrolled over 2.5 years through the Etiology of Pneumonia in the Community (EPIC) study. NP/OP specimens with matching high-quality sputum (defined as ≤10 epithelial cells/lowpower field [lpf] and ≥25 white blood cells/lpf or a quality score [q-score] definition of 2+) were tested by TaqMan array card (TAC), a multipathogen real-time PCR detection platform. Among 236 patients with matched specimens, a higher proportion of sputum specimens had ≥1 pathogen detected compared with NP/OP specimens in children (93% versus 68%; P < 0.0001) and adults (88% versus 61%; P < 0.0001); for each pathogen targeted, crossing threshold (CT) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.

Original languageEnglish (US)
Pages (from-to)110-121
Number of pages12
JournalJournal of clinical microbiology
Volume55
Issue number1
DOIs
StatePublished - Jan 2017

Keywords

  • Community-acquired pneumonia
  • Diagnostics
  • Multipathogen
  • NP/OP
  • Pneumonia
  • Sputum
  • TAC
  • TaqMan array card

ASJC Scopus subject areas

  • Microbiology (medical)

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