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Q fever pneumonia in children in Japan
Abstract:
The prevalence of Q fever pneumonia among children with atypical pneumonia from whom only an acute-phase serum sample was available was traced by using an indirect immunofluorescence (IF) test, nested PCR, and isolation. Twenty (34.5%) of 58 sera were found to have both polyvalent and immunoglobulin M antibodies to the phase II antigen of Coxiella burnetii by the IF test. Q fever pneumonia was present in 23 (39.7%) of 58 patients as determined by both the nested PCR and isolation and in 20 patients as determined by the IF test. The sensitivities for nested PCR and isolation were 100%, and that for the IF test was 87%. Our results indicate that nested PCR was faster and more sensitive than isolation and the IF test in the diagnosis of acute Q fever when a single acute-phase serum was available. These findings suggest that C. burnetii is an important cause of atypical pneumonia in children in Japan.
Insights
Coxiella burnetii causes Q fever pneumonia in children. Nested PCR is a faster, more sensitive diagnostic method for acute Q fever using a single serum sample.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Molecular Diagnostics
Background:
- Q fever, caused by Coxiella burnetii, is an important zoonotic infection.
- Atypical pneumonia in children presents diagnostic challenges, especially with limited sample availability.
- Accurate and rapid diagnosis of Q fever pneumonia is crucial for timely treatment.
Purpose of the Study:
- To determine the prevalence of Q fever pneumonia in children with atypical pneumonia.
- To compare the diagnostic performance of indirect immunofluorescence (IF) test, nested PCR, and isolation using acute-phase serum.
- To evaluate the utility of nested PCR for diagnosing acute Q fever in children.
Main Methods:
- Sera from 58 children with atypical pneumonia were tested.
- Indirect immunofluorescence (IF) test was used to detect antibodies to Coxiella burnetii.
- Nested PCR and bacterial isolation were employed for direct detection of Coxiella burnetii.
- Diagnostic sensitivities of IF, nested PCR, and isolation were compared.
Main Results:
- Q fever pneumonia was diagnosed in 39.7% of patients by nested PCR and isolation, and 34.5% by IF test.
- Nested PCR and isolation demonstrated 100% sensitivity, while the IF test showed 87% sensitivity.
- Nested PCR was found to be faster and more sensitive than isolation and IF test.
Conclusions:
- Coxiella burnetii is a significant cause of atypical pneumonia in children in Japan.
- Nested PCR is a highly sensitive and rapid diagnostic tool for acute Q fever when only a single acute-phase serum is available.
- Diagnostic strategies should consider nested PCR for improved detection rates in pediatric Q fever cases.