title: Evaluation of a rapid antigen test for detection ofStreptococcus pneumoniaein cerebrospinal fluid.
abstract: Detection ofStreptococcus pneumoniaeantigen in cerebrospinal fluid (CSF) using lateral flow immunochromatography tests (ICTs) is an effective, rapid and low-cost method to diagnose pneumococcal meningitis. This study evaluated the diagnostic accuracy of the Uni-Gold ICT to detect pneumococcal antigen in CSF specimens, compared with gold standard bacteriology and quantitative real-time PCR (qPCR) testing. CSF specimens (n=69) from patients with suspected bacterial meningitis were included in the study. 13/69 (19%) were positive and 56/69 (81%) were negative for pneumococcus by the gold standard tests. The ICT had sensitivity of 85% (55%-98%), specificity of 96% (88%-100%), positive likelihood ratio of 23.7 (6-94) and negative likelihood ratio of 0.16 (0.04-0.57). Overall, a strong correlation between the ICT and qPCR results was seen (κ=0.81). In contrast, CSF microscopy and culture were exceptionally insensitive. The ICT method is sufficiently robust and accurate for use in algorithms to diagnose bacterial meningitis.
authors.affiliation: Department of Microbiology, Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK.
authors.forename: Angel
authors.initials: A
authors.lastname: Boulos
authors.affiliation: Department of Microbiology, Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK.|Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Fairley
authors.affiliation: Department of Microbiology, Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK.
authors.forename: James
authors.initials: J
authors.lastname: McKenna
authors.affiliation: Department of Microbiology, Belfast Health & Social Care Trust, Belfast, Northern Ireland, UK.|Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Coyle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D002846:Chromatography, Affinity / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D013997:Time Factors; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial
keywords: ANTIGENIC EPITOPES; MENINGITIS; STREPTOCOCCI; STREPTOCOCCUS