title: Performance of a pneumolysin enzyme-linked immunosorbent assay for diagnosis of pneumococcal infections.
abstract: A pneumolysin-specific enzyme-linked immunosorbent assay (PLY-ELISA) for the detection of pneumolysin in urine was developed and evaluated in comparison with the commercially available Binax Now Streptococcus pneumoniae test (Binax, Portland, ME) for the diagnosis of pneumococcal infections. Assay sensitivity was evaluated using urine from 108 patients with culture-confirmed pneumococcal infections. In adults, the sensitivity and specificity of the PLY-ELISA were 56.6% and 92.2%, respectively. In children with nasopharyngeal pneumococcal carriage, PLY-ELISA and Binax Now S. pneumoniae test sensitivities were 62.5% and 87.5%, respectively, while specificities were 94.4% and 27.8%, respectively. In children with nonnasopharyngeal pneumococcal carriage, PLY-ELISA and Binax Now S. pneumoniae test sensitivities were 68.7% and 93.7%, respectively, and test specificities were 94.1% and 41.2%, respectively. The persistence of pneumolysin in urine of pneumococcal pneumonia patients decreased significantly after 4 to 6 days of treatment. Our data suggest that combining the high specificity of the PLY-ELISA with the high sensitivity of the Binax Now S. pneumoniae test would enable pneumococcal infections to be accurately diagnosed in children.
authors.affiliation: Area de Microbiología, Facultad de Medicina, C/Julián Clavería No 6, 33006 Oviedo, Asturias, Spain. garciamar@uniovi.es
authors.forename: María
authors.initials: M
authors.lastname: del Mar García-Suárez
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Cima-Cabal
authors.forename: Roberto
authors.initials: R
authors.lastname: Villaverde
authors.forename: Emma
authors.initials: E
authors.lastname: Espinosa
authors.forename: Miquel
authors.initials: M
authors.lastname: Falguera
authors.forename: Juan R
authors.initials: JR
authors.lastname: de Los Toyos
authors.forename: Fernando
authors.initials: F
authors.lastname: Vázquez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Méndez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000652:urine; D012680:Sensitivity and Specificity; D013301:Streptolysins / Q000652:urine*
chemical_list: D001426:Bacterial Proteins; D013301:Streptolysins; C032290:plY protein, Streptococcus pneumoniae