ESPOSITO S, COLOMBO R, CARLUCCI P, FAELLI N, BOSIS S, FOSSALI E, PRINCIPI N; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. D-1689.
Inst. Paediatr., Univ. Milan, Milan, Italy.
BACKGROUND: Streptococcus pneumoniae (Sp) remains a major cause of morbidity and mortality worldwide despite the licensure of an effective pneumococcal conjugate vaccine. In an era of increasing antimicrobial resistance, identification of pneumococcal disease may have importance for the choice of the best antibiotic therapy. This study evaluated the usefulness of the rapid assay approved by the FDA for distinguishing children with pneumococcal infection. METHODS: A total of 134 children with suspected pneumococcal disease (89 pneumonia, 43 fever without source, and 2 meningitis) aged 1-60 months and 139 age-matched healthy controls were prospectively enrolled. Blood samples for culture were obtained from all patients; both patients and controls provided nasopharyngeal swabs for culture and urine samples for pneumococcal antigen detection test (Binax NOW; Binax). RESULTS: Binax NOW assay resulted positive in 4 out of 4 patients with confirmed invasive pneumococcal disease (IPD), all with blood culture positive for Sp. It resulted positive also in 26/130 patients with negative blood culture (20%; p=0.002 vs IPD) and in 17/139 healthy controls (12.2%; p=0.0003 vs IPD). The urine antigen detection test was significantly more likely to be positive for children who were nasopharyngeal carriers of pneumococci than for those who were not. This was true for patients with negative blood culture (51.5% vs 9.3%; p<0.0001) and for healthy controls (30.2% vs 9.7%; p=0.009). CONCLUSIONS: Binax NOW assay appears to be useful for excluding pneumococcal infection but not for distinguishing patients with pneumococcal disease from those who were merely colonized. The predictive value of a positive result of this and other urine antigen detection tests should be further evaluated in studies that also assess nasopharyngeal colonization.
Publication Types:
Keywords:
- Antigens, Bacterial
- Carrier State
- Case-Control Studies
- Child
- Humans
- Immune Sera
- Nasopharynx
- Pneumococcal Infections
- Pneumococcal Vaccines
- Streptococcus pneumoniae
- analysis
- immunology
- methods
Other ID:
UI: 102265139
From Meeting Abstracts