TY - JOUR AU - Nikkari, Simo AU - Lopez, Fred A. AU - Lepp, Paul W. AU - Cieslak, Paul R. AU - Ladd-Wilson, Stephen AU - Passaro, Douglas AU - Danila, Richard AU - Relman, David A. T1 - Broad-Range Bacterial Detection and the Analysis of Unexplained Death and Critical Illness T2 - Emerging Infectious Disease journal PY - 2002 VL - 8 IS - 2 SP - 188 SN - 1080-6059 AB - Broad-range rDNA polymerase chain reaction (PCR) provides an alternative, cultivation-independent approach for identifying pathogens. In 1995, the Centers for Disease Control and Prevention initiated population-based surveillance for unexplained life-threatening infections (Unexplained Death and Critical Illness Project [UNEX]). To address the causes of UNEX cases, we examined 59 specimens from 46 cases by using broad-range bacterial 16S rDNA PCR and phylogenetic analysis of amplified sequences. Specimens from eight cases yielded sequences from Neisseria meningitidis (cerebrospinal fluid from two patients with meningitis), Streptococcus pneumoniae (cerebrospinal fluid from one patient with meningitis and pleural fluid from two patients with pneumonia), or Stenotrophomonas maltophilia (bone marrow aspirate from one patient with pneumonia). Streptococcus pneumoniae rDNA sequence microheterogeneity was found in one pleural fluid specimen, suggesting the presence of multiple strains. In conclusion, known bacterial pathogens cause some critical illnesses and deaths that fail to be explained with traditional diagnostic methods. KW - Neisseria meningitidis KW - Streptococcus pneumoniae KW - rRNA KW - PCR KW - diagnosis KW - DNA KW - ribosomal KW - United States DO - 10.3201/eid0802.010150 UR - https://wwwnc.cdc.gov/eid/article/8/2/01-0150_article ER - End of Reference