title: Comparison of Binax NOW urine antigen test and pneumococcal DNA assay using qPCR before and after nasopharyngeal swabbing in healthy Malawian children.
abstract: Diagnosis of invasive pneumococcal disease is challenging. We compared Binax NOW pneumococcal urinary antigen test with blood pneumococcal PCR in healthy Malawian children with and without pneumococcal carriage, and we found a high false-positive rate with Binax NOW. Blood pneumococcal PCR positivity was 66/88 (75%) compared to 5/27 (18%) when nasopharyngeal swabbing was performed first compared to after blood sampling for pneumococcal blood PCR. We speculate that nasopharyngeal swabbing may be causing a breach of mucosal integrity, leading to invasion into the bloodstream. These findings need to be confirmed with autolysin-based PCR assays.
authors.affiliation: Department of Clinical Pharmacology, University of Liverpool Institute of Translational Medicine, United Kingdom.
authors.forename: E A
authors.initials: EA
authors.lastname: Lees
authors.affiliation: Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Alder Hey Children's NHS Foundation Trust, United Kingdom.
authors.forename: D K K
authors.initials: DK
authors.lastname: Ho
authors.affiliation: Public Health England North West, Manchester Laboratory, Manchester Medical Microbiology Partnership, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Guiver
authors.affiliation: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Malawi.
authors.forename: L A
authors.initials: LA
authors.lastname: Mankhambo
authors.affiliation: Department of Clinical Infection, Microbiology and Immunology, University of Liverpool Institute of Infection and Global Health, Liverpool, United Kingdom ; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Malawi.
authors.forename: N
authors.initials: N
authors.lastname: French
authors.affiliation: Department of Clinical Infection, Microbiology and Immunology, University of Liverpool Institute of Infection and Global Health, Liverpool, United Kingdom ; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Malawi.
authors.forename: E D
authors.initials: ED
authors.lastname: Carrol
keywords: Binax NOW urine antigen test; DNAaemia; invasive pneumococcal disease; nasopharyngeal swabbing; pneumococcal PCR