title: Pleural antigen assay in the diagnosis of pediatric pneumococcal empyema.
abstract: OBJECTIVE
  The purpose of the study was to assess the diagnostic value of rapid pneumococcal antigen detection (PAD) in pleural fluid samples of children with empyema.
  
  
  METHODS
  We performed a prospective evaluation in a pediatric intensive care unit of a tertiary university hospital of children aged 1 month to 14 years admitted with empyema. Standard cultures (conventional microbiological culture [CMC]), PAD by immunochromatographic testing (Binax NOW Streptococcus pneumoniae; Binax, Portland, ME), and/or real-time polymerase chain reactions (RTPs) on pleural samples were performed in all included patients.
  
  
  RESULTS
  Fifty-five cases with a mean (SD) age of 6.5 (6.1) years were enrolled. Streptococcus pneumoniae was identified in 28 cases (51%): by CMC in 15 cases and by RTP in a further 13 cases. Using CMC and/or RTP as the criterion standard, PAD showed a sensitivity of 96% (95% confidence interval, 86%-100%), a specificity of 100% (75%-100%), a positive predictive value of 100% (98%-100%), and a Youden index of 0.96 (0.88-1.04).
  
  
  CONCLUSIONS
  Pneumococcal antigen detection in pleural fluid specimens from children provides a rapid, simple, sensitive, and reliable method of diagnosis for pneumococcal empyema at bedside.
authors: Pediatric Critical Care Unit, Servicio de Críticos, Intermedios y Urgencias Pediátricas, Area de Pediatria, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. federico.martinon.torres@sergas.es
authors: Federico
authors: F
authors: Martinón-Torres
authors: Silvia
authors: S
authors: Dosil-Gallardo
authors: María Luisa
authors: ML
authors: Perez del Molino-Bernal
authors: Fernanda Pardo
authors: FP
authors: Sánchez
authors: David
authors: D
authors: Tarrago
authors: Fernando
authors: F
authors: Alvez
authors: Sonia Pertega
authors: SP
authors: Diaz
authors: Nazareth
authors: N
authors: Martinón-Torres
authors: Jose Maria
authors: JM
authors: Martinon Sanchez
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002846:Chromatography, Affinity; D016724:Empyema, Pleural / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D010996:Pleural Effusion / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012703:Serotyping / Q000379:methods; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*
chemical_list: D000942:Antigens, Bacterial