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Objective:To explore the value of FilmArray meningitis/encephalitis(ME)Panel in etiological diagnosis of infection in central nervous system(CNS) in Chinese children.Methods:Cerebrospinal fluid(CSF)obtained through lumbar puncture was collected from 145 patients with suspected CNS infection at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from March 2019 to November 2019.All specimens were cultured simultaneously, which were detected by FilmArray ME Panel, and the results of cerebrospinal fluid culture and FilmArray ME Panel were compared.Results:Among 145 patients with suspected CNS infection, three samples were found to be positive after cerebrospinal fluid culture, and the positive rate was 2.1%(3/145). For the FilmArray ME Panel, 30 specimens were found to be positive, with a positive rate of 20.7%(30/145), and the difference of positive rate between the two methods was statistically significant( χ2=24.927, P<0.05). Among the samples FilmArray ME Panel tested positive with pathogen, 26 specimens were positive with virus making up 17.9%(26/145)and enterovirus(15.2%)was the primary pathogen.In addition, of the 142 specimens cerebrospinal fluid culture negative, 28 samples were tested positive by the FilmArray ME Panel, accounting for 19.7%(28/142). Conclusion:FilmArray ME Panel has the characteristics with high positive rate and could be time-saving.Meanwhile, FilmArray ME Panel has significant advantage in the detection of virus and improves the positive detection rate of virus.
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Objective To investigate the clinical features and pathogenic types of suspected pertussis syndrome in infants,so as to provide reference for the treatment. Methods Seventy-one infants of suspected pertussis in Shanghai Children′s Medical Center from Nov 2016 to Aug 2017 were detected by the Filmarray which can detect Bordetella pertussis and 17 viruses. According to the results,the infants were divided into two groups:pertussis group(n=29) and pertussis-like group(n=42). According to the severity of the dis-ease,they were divided into mild group(n=50) and severe group(n=21). Clinical data was retrospectively analyzed and compared. Results All 71 infants came to the hospital with cough. Paroxysmal cough happened in 18 cases(62. 1％)in pertussis group,more common than that in pertussis-like group[9 cases(21. 4％)] (χ2 =12. 023,P<0. 01),and the WBC count,lymphocyte ratio,the mixed virus infection rate were higher in pertussis group than those in pertussis-like group[(20. 00 ± 8. 62) × 109/L vs. (13. 42 ± 6. 58) × 109/L,t=-3. 647,P<0. 01;(70. 38 ± 8. 97)％ vs. (56. 26 ± 20. 38)％,t = -3. 967,P <0. 01;22 cases(75. 9％) vs. 16 cases(38. 1％),χ2 =9. 836,P<0. 01]. The cases of mixed bacterial infection in pertussis-like group were 13(31. 0％),which was higher than that in pertussis group[3(10. 3％)](χ2 =4. 173,P<0. 05). The incidence of cyanosis was found in 12 cases(57. 1％)in severe group,which was more common than that of mild group[12 cases(24. 0％)](χ2 =7. 260,P<0. 01), and hospitalization days were(14. 5 ± 7. 8) days, which was higher than that in mild group[(7. 0 ± 3. 1)days] (t= -4. 250, P<0. 01). The infants in the pertussis group were given macrolides antibiotics and sulfamethoxazole complex,and the infants in the pertus-sis-like group were treated with antiviral and other specific treatment. Among 71 infants, 67 cases (94. 4％) were cured and 3 cases (4. 2％) were improved. Conclusion The clinical features of suspected pertussis in infants are not typical, so the early pathogenic diagnosis is very important. Filmarray detection system for multi PCR system can detect 20 kinds of pathogens with short operation time,which is very helpful for the early and rapid diagnosis of pathogens and rational use of drugs. It is worthy of clinical promotion.
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Objective To evaluate the clinical efficacy and application value of FilmArray Respiratory Panel(FilmArray RP)for Mycoplasma pneumoniae(MP)detection.Methods Methodological evaluation.A total of 360 nasopharyngeal swabs or sputum samples were collected from hospitalized children with community acquired pneumonia in Shanghai Children′s Medical Center,Shanghai Jiao Tong University School of Medicine(SCMC)from November 2016 to May 2017.Among them, there were 197 males and 163 females.There were 185 cases in 0-2 years old group,116 cases in 3-6 years old group and 59 cases in 7-16 years old group.FilmArray RP and serological test were respectively used to detect MP infection. Polymerase chain reaction(PCR)was also performed on all the positive samples of MP detected by FilmArray RP,negative samples of FilmArray RP but positive by serological test and some negative samples of the two test methods selected by simple random sample.The results of FilmArray RP and serological test,the positive rates of different age groups detected by FilmArray RP and the rates of MP combined with virus were statistically analyzed by χ2test.Results Among 360 patients with community acquired pneumonia,39 (10.83%,39/360)were MP positive detected by FilmArray RP.In contrast,93 patients(25.83%,93/360)were diagnosed as MP infections using serological test.Results from the two methods were statistically significant(χ2=27.05, P=0.00).Among them, 39 cases of MP detected by FilmArray RP were also positive by PCR.Sixty-one negative samples of FilmArray RP but positive by serological test and 22 negative samples of the two test methods selected by simple random sample were also negative by PCR.Among the positive samples detected by FilmArray RP,the positive rate of patients aged 7-16 years(28.81%,17/59) was higher than that of patients aged 0-2 years(5.95%,11/185)and patients aged 3-6 years(9.48%,11/116).The positive rates of different age groups were statistically significant(χ2=24.54, P=0.00).The proportion of MP combined with virus infection in 0-2 years old group(81.82%,9/11)was higher than that in 3-6 years old group(45.45%,5/11)and 7-16 years old group(29.41%,5/17),the difference was statistically significant(χ2=7.41, P=0.03).Conclusions FilmArray RP is a rapid method in MP detection.It has great advantages in the detection of MP and virus mixed infection.
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Objective To explore the value of polymerase chain reaction(PCR) to detect pathogens in ventilator-associated pneumonia(VAP) in children undergoing congenital heart disease(CHD) operation. Methods Forty-eight children selected from 95 cases with VAP underwent CHD operation were admitted in the department of CICU in our hospital from November 2016 to July 2017.Sputum specimens were separately collected by the bronchoalveolar lavage(BAL) and endotracheal tube attracts(ETA) methods,and the patho-gens were detected by culture and PCR assay.Results Nineteen specimens were found to be positive after 72 h of culture.A total of 20 pathogens were detected and 2 samples were mixed infection(more than one pathogen),and the positive rate was 39.2%(19/48).For PCR assay,44 pathogens from 31 samples were detected for just 24 h,22 samples were single pathogen infection,9 samples were mixed pathogen infection, and the positive rate was 65.3%(31/48).Compared with culture method,PCR assay could sharply increase the detection rate of every pathogen.Besides,the positive rate of the BAL or ETA for PCR assay was almost the same(45/48). Conclusion PCR assay for detecting pathogens is rapid,accurate and effective,which should be combined with culture method to detect for infectious pathogen.The ETA is the desired method to collect the sputum of the patients.