Use of Dipstick Assay and Rapid PCR-DNA Analysis of Nasal Secretions for Diagnosis of Bacterial Sinusitis in Children With Chronic Cough.

IF 2.3 Q1 OTORHINOLARYNGOLOGY
Allergy & Rhinology Pub Date : 2019-01-07 eCollection Date: 2019-01-01 DOI:10.1177/2152656718821281
Charles Song, Jeena Chorath, Youngju Pak, Nasser Redjal
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Abstract

Background: Chronic cough in children is a diagnostic challenge.

Objective: To discover the utility of nasal dipsticks and polymerase chain reaction (PCR)-DNA analysis in differentiating bacterial sinusitis from other causes of chronic cough and identifying pathogens from the nasal cavity.

Method: We recruited 22 patients under 15 years of age with cough lasting longer than 4 weeks (group 1), 7 controls with allergic rhinitis (group 2), and 10 controls without respiratory symptoms (group 3). Based on symptoms, the results of nasal secretion assays, and nasal endoscopy, a diagnosis of clinical bacterial sinusitis was made. We identified potential pathogens by quantitative PCR of nasal secretions.

Results: Group 1A (cough with clinical bacterial sinusitis n = 10): Eight (80%) patients had bacterial sinusitis associated with dominant potential pathogenic bacteria (PPB): Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Group 1B (cough without clinical bacterial sinusitis n = 12): None had dominant PPB. Group 2 (allergic rhinitis n = 7): None had dominant PPB. Group 3 (asymptomatic n = 10): None had dominant PPB. Twenty to 57% of all groups were colonized with Staphylococcus aureus. Fifty to 70% were colonized with Staphylococcus epidermidis, Corynebacterium pseudodiphtheriticum, and Dolosigranulum pigrum.

Conclusion: In children with chronic cough, clinicians can utilize a simple and inexpensive nasal secretion dipstick assay for rapid diagnosis of sinusitis and identify PPB by DNA-PCR test for specific antibiotic treatment.

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Dipstick法和鼻腔分泌物快速PCR-DNA分析在诊断慢性咳嗽儿童细菌性鼻窦炎中的应用。
背景:儿童慢性咳嗽是一个诊断挑战。目的:探讨鼻拭子和聚合酶链式反应(PCR)-DNA分析在鉴别细菌性鼻窦炎和其他慢性咳嗽病因以及鉴别鼻腔病原体方面的实用性。方法:我们招募了22名15岁以下咳嗽持续时间超过4周的患者(第1组)、7名过敏性鼻炎对照组(第2组)和10名无呼吸道症状对照组(3组)。根据症状、鼻腔分泌物测定和鼻内镜检查结果,诊断为临床细菌性鼻窦炎。我们通过鼻腔分泌物的定量PCR鉴定了潜在的病原体。结果:1A组(咳嗽伴临床细菌性鼻窦炎) = 10) :8名(80%)患者患有与显性潜在致病菌(PPB)相关的细菌性鼻窦炎:肺炎链球菌、流感嗜血杆菌和卡他莫拉。1B组(无临床细菌性鼻窦炎的咳嗽) = 12) :无一例具有显性PPB。第2组(过敏性鼻炎n = 7) :无一例具有显性PPB。第3组(无症状n = 10) :无一例具有显性PPB。所有组中有20%至57%被金黄色葡萄球菌定植。50%至70%的细菌定植于表皮葡萄球菌、假白喉棒状杆菌和猪多颗粒菌。结论:在儿童慢性咳嗽中,临床医生可以利用一种简单、廉价的鼻腔分泌物量尺法快速诊断鼻窦炎,并通过DNA-PCR试验鉴定PPB以进行特异性抗生素治疗。
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来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
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