Antigen detection for the diagnosis of pneumonia.
Streptococcus pneumoniae and Haemophilus influenzae type b are the main agents of bacterial community-acquired pneumonia in developing countries, although a definite etiologic diagnosis cannot be established in most cases. This study was carried out to assess the performance of a latex particle agglutination test (LPAT) from a commercial kit (Slidex Méningite Kit trade mark, BioMérieux, France) in diagnosing pneumococcal and H. influenzae type b pneumonia. One hundred and seven children (45 ill subjects and 62 healthy controls) were enrolled. All 45 cases had a presumptive diagnosis of bacterial pneumonia based on clinical (WHO criteria), laboratory (white blood cell count > or = 15.000/mm3, polymorphonuclear leukocytes > or = 70%, bands > or = 500/mm3, and C-reactive protein > or = 40 mg/l), and radiological findings, i.e., two or more positive points in the scoring system described by Khamapirad and Glezen (Semin Respir Infect 1987;2:130-144). Clinical, laboratory, and radiological assessments were performed in a blinded manner. LPAT was performed in urine samples after concentration through an ethanol-acetone solution. Sensitivity, specificity, and positive and negative predictive values were 77.3% (95% CI, 61.8-88.0%), 90.3% (95% CI, 79.5-96.0%), 85.0% (95% CI, 69.5-93.8%), and 84.8% (95% CI, 73.4-92.1%), respectively. Results suggest that LPAT is a useful diagnostic tool for the etiologic diagnosis of S. pneumoniae and H. influenzae type b pneumonia, especially in the developing world.
Nunes
Altacílio A
AA
Department of Pediatrics, Medical School, University of Uberaba, Brazil.
Camargos
Paulo A M
PA
Costa
Petrônio R
PR
Campos
Maria Tereza K
MT
D000942:Antigens, Bacterial / Q000652:urine*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis* / Q000276:immunology; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006801:Humans; D007841:Latex Fixation Tests / Q000379:methods; D008297:Male; D008863:Microspheres; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000276:immunology*
D000942:Antigens, Bacterial; D011933:Reagent Kits, Diagnostic