Usefulness of pneumococcal antigen detection in pleural fluid samples by immunochromatographic assay for diagnosis of pneumococcal pneumonia

Abstract

This study investigated the utility of an immunochromatographic test (ICT) for the detection of Streptococcus pneumoniae antigens in pleural fluid. Antigen was detected in 15 of 19 (79%) patients with pneumococcal pneumonia. The ICT was always negative in patients with non-pneumococcal pneumonia, but was positive in three cases with a non-infectious aetiology. In patients with pneumonia for which no pathogen was identified, antigen was detected in one of 24 pleural fluids tested. The ICT can be a valuable tool for the management of pneumonia because it can detect pneumococcal antigen in pleural effusion samples.

Usefulness of pneumococcal antigen detection in pleural effusion for the rapid diagnosis of infection by Streptococcus pneumoniae

“…The test proved negative in 20 documented cases of empyema due to other bacteria and there were two false positives (95% specificity). Andreo et al [2] found a sensitivity and specificity of 79% and 93.6%, respectively, for the pneumococcal antigen immunochromatographic test in parapneumonic pleural effusions diagnosed by conventional microbiologic methods, but not by PCR, thus explaining the better specificity. Charkaluk et al [3] evaluated the efficacy of the test in 287 children with suggestive clinical signs, not only with pleural effusion, and detected a high sensitivity (100%), low specificity (55.9%), and 10.7% of false negatives in nasopharyngeal carriers.…”

“…This test has been validated for urine and cerebrospinal fluid [3,10,11,15], and has recently been studied for pleural fluid [2,8,12,13].…”

Novel Approaches to the Identification ofStreptococcus pneumoniaeas the Cause of Community‐Acquired Pneumonia

“…Bacteremic infections tend to have higher rates of positivity [50,52]. Promising results have been reported for testing of pleural fluid for the diagnosis of empyema [44,53]. Finally, ICT has been used for management decisions.…”

Early diagnosis of lower respiratory tract infections (point-of-care tests)

“…Unlike in the case of patients with pneumococcal pneumonia or bacteremia, failures with b-lactam drugs is well described for meningitis [65][66][67]; so this test could be used to identify subsets of patients with meningitis that are more likely to benefit from the addition of a glycopeptide such as vancomycin to the standard antibiotic regimen. It can also be used with reasonable accuracy on samples of pleural fluid [68,69 ] and bronchoalveolar lavage fluid [70].…”