ABSTRACT
Introduction: Understanding the immunopathogenesis of bacterial infection has led to a marked improvement in the investigational diagnosis. M. pneumoniae is a common atypical bacterium that cause community acquired pneumonia [CAP]. As many diverse microorganisms cause CAP, identification of the etiological cause is essential to guide antibiotic administration. Currently, laboratory diagnosis of M. pneumoniae is unsatisfactory, pediatricians around the word invented clinical scores to help in identifying the cause of CAP
The aim of this work was to introduce Neutrophil/ lymphocyte ratio as a simple, easy and reliable method to assist in the rapid diagnosis of M. pneumonia and to reevaluate the cut off value of M. pneumoniae clinical score [The CAF score suggested by Rodríguez and colleagues]
Methodology: This prospective cross sectional study included 50 children from the age of 4 to 12 years old. Cases were selected according to the CAF clinical score. All patients were subjected to full examination and laboratory evaluation including C.B.C, CRP and Chest x-ray.Oropharyngeal swabs were used to isolate M. pneumoniaeand diagnosis was made by PCR
Results: There were 6 cases positive for M. pneumoniae[12%] out of 50 patient cases. ROC curve of NLR reveals a statistically significant difference between cases infected with M. pneumoniae and other non infected cases [P value= 0.01]. NLR= 2.1 is suggestive for M. pneumoniae infection with a sensitivity of 50% and specificity of 95%. ROC curve of CAF score reveals that scores above 10 are diagnostic M. pneumoniae infection with sensitivity of 100% and specificity of 44.19%
Conclusion:NLR is a valuable addition to the diagnosis of M. pneumoniae as an important cause of CAP. Also, we suggest raising the cut off value of CAF score from 5 to 10 to improve the sensitivity of the score with a mild decrease in the specificity. Using both diagnostic tools probably enhance the diagnosis of CAP caused by M. pneumoniae
ABSTRACT
Rotavirus gastroenteritis is a leading cause of diarrheal disease mortality among children under five years, mostly in developing world. This study aimed to detect rotavirus among 40 hospitalized infants and children with acute gastroenteritis whose ages ranged from 2-24 months, 22 males and 18 females. Also, a control group of 15 healthy infants and children with a matched age and sex were included in the study. Three different commercial tests for detection of group A rotavirus [Latex agglutination [LA], enzyme linked immunosorbent assay [ELISA] and reverse-transcriptase PCR [RT-PCR]] were used to evaluate fecal specimens obtained from the patients and control group. LA test detected the virus in 24 cases [60%], while the result was 19 cases [47.5%] with ELISA and only 17 cases [42.5%] with RT-PCR. Genotyping showed presence of VP4 gene [P genotype] in 8 cases, VP7 [G genotype] in 6 cases, and a mixed VP4 and VP7 [P and G genotypes] in 3 cases of PCR positive diarrheal samples. The severe clinical manifestations were associated with VP7 genotype. Infection was more in artificial fed infants than breast fed with a significant difference [P <0.05]. Also, infection was more frequent in winter season. Considering PCR as a gold standard, our study reported that ELISA and LA test had a sensitivity of 94.1% and 82.4% respectively and a specificity of 92.1% and 73.7% respectively. In conclusion, ELISA is rapid, sensitive and specific test for detection of rotavirus in stool samples, while RT-PCR is an important method for viral genotyping