Diagnostic Utility of Rapid Immunochromatographic Urine Antigen Testing in Suspected Pneumococcal Infections

Anjay, M A; Anoop, Parameswaran

doi:10.1136/adc.2008.138958

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…Several prospective studies and a systematic review have concluded that a simple immunochromatographic lateral flow test for pneumococcal C polysaccharide antigens in urine has high sensitivity (close to 100%) for invasive pneumococcal infection but lacks specificity (60-80%), particularly in children with nasopharyngeal pneumococcal carriage. [115][116][117] More recently, an immunodiagnostic assay for serotype specific detection of polysaccharides from 13 different pneumococcal serotypes (those found in PCV13) has been developed, 118 and it has been shown to be sensitive and specific (98% and 100%, respectively, when using bacteremic episodes with one of the 13 serotypes included in the test as the reference) for pneumococcal pneumonia in adults. 119 However, this test is likely to also be positive in people with nasopharyngeal carriage of pneumococci.…”

Section: Emerging Diagnosticsmentioning

confidence: 99%

Advances in the diagnosis of pneumonia in children

Zar

Andronikou

Nicol

2017

BMJ

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Pneumonia remains a major cause of childhood mortality and morbidity globally. Accurate diagnosis and attribution of the causes of pneumonia are important for measuring the burden of disease, implementing appropriate preventive or treatment strategies, and developing more effective interventions. This review summarizes recent diagnostic advances in radiological techniques, specimen collection, and laboratory methods. Although chest ultrasound and chest magnetic resonance imaging are promising modalities for radiological diagnosis, their role in clinical management and their impact on outcomes need further study. Rapid, highly sensitive, multiplex laboratory tests performed on upper respiratory tract samples or induced sputum can detect nucleic acid from potential pathogens in most children with pneumonia. However, it may be difficult to attribute causality because it is often impossible to distinguish between organisms colonizing or infecting the upper respiratory tract and those causing pneumonia. Currently available host biomarkers lack accuracy for distinguishing bacterial or mixed bacterial-viral infections from viral infections. New biomarkers derived from host transcriptional profile analysis may be more accurate but require validation. Prospective studies with appropriate control populations, including studies of clinical impact, are needed to improve our understanding of the role of tests. Although progress has been made in radiological techniques and laboratory testing, current methods for diagnosing and attributing the causes of pneumonia are suboptimal.

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Section: Emerging Diagnosticsmentioning

confidence: 99%

Advances in the diagnosis of pneumonia in children

Zar

Andronikou

Nicol

2017

BMJ

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“…However, in childhood, a false positive result can occur as a result of recent pneumococcal vaccination or ongoing nasopharyngeal carriage. A positive result should therefore be interpreted with caution, although a number of studies have demonstrated that a negative urine antigen test practically rules out pneumococcal infection 35 36…”

Section: Pneumococcal Urinary Antigen Testingmentioning

confidence: 99%

Update on the causes, investigation and management of empyema in childhood

Walker

Wheeler

Legg

2010

Archives of Disease in Childhood

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Despite being recognised for over two millennia and having an increasing incidence in many countries, the management of childhood empyema remains controversial. This review examines the recent literature on its causes and investigation then focuses on its treatment. Following a trial of appropriate intravenous antibiotics, the evidence would currently support the use of chest drain insertion with urokinase instillation as first line treatment with video-assisted thoracoscopic surgery to be used for failure of medical management. A treatment algorithm is proposed to guide clinical practice.

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“…An indirect evidence of the polysaccharide absorption during carriage is the association of pneumococcal C polysaccharide detection in urine with pneumococcal carriage in healthy children [13][14][15][16]. Our objective was therefore to determine whether nasopharyngeal carriage of S. pneumoniae serotypes included in PCV7, at or immediately before the first PCV7 dose, affects the response to the primary immunization series and/or to the booster dose.…”

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confidence: 99%