Novel approaches to the identification of Streptococcus pneumoniae as the cause of community-acquired pneumonia.
Current diagnostic tests lack sensitivity for the identification of the bacterial etiology of pneumonia. Attempts during the past 2 decades to improve sensitivity of detection of bacterial constituents in blood by use of antibody-antigen complexes and polymerase chain reaction have been disappointing. Recent data using pneumococcal conjugate vaccines as probes suggest that increased levels of both C-reactive protein and procalcitonin may be useful adjuncts to chest radiographs in the selection of patients with presumed bacterial pneumonia for inclusion in clinical trials. Among pneumococcal diagnostics currently under investigation, quantitative real-time polymerase chain reaction of respiratory secretions, as well as urinary antigen detection and pneumococcal surface adhesin A serological analysis for adults, are candidates for use in future clinical trials of antibiotics.
Klugman
Keith P
KP
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. keith.klugman@emory.edu
Madhi
Shabir A
SA
Albrich
Werner C
WC
D000328:Adult; D000942:Antigens, Bacterial / Q000652:urine; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000382:microbiology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods; D011498:Protein Precursors / Q000097:blood; D013902:Radiography, Thoracic; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
D000942:Antigens, Bacterial; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide