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The Binax NOW Streptococcus pneumoniae test applied on nasopharyngeal aspirates to support pneumococcal aetiology in community-acquired pneumonia.
Örebro University Hospital.ORCID iD: 0000-0002-8730-6955
Örebro University Hospital, Örebro, Sweden; Karolinska University Hospital, Stockholm, Sweden.
2013 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, no 6, p. 425-31Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The use of nasopharyngeal secretions to enhance diagnostic yields of pneumococcal aetiology in community-acquired pneumonia (CAP) is of interest. We evaluated the Binax NOW Streptococcus pneumoniae immunochromatographic test (ICT) on nasopharyngeal aspirates (NPA) in order to support pneumococcal aetiology in CAP.

METHODS: The NPA ICT was applied on 180 adult CAP patients and 64 healthy controls. The rate of pneumococcal detection in the nasopharynx was compared to rates for lytA polymerase chain reaction (PCR) and culture on NPA.

RESULTS: According to blood and sputum culture and urine ICT, the test sensitivity in 59 patients with a pneumococcal aetiology was 81%. The specificity was suboptimal, with 72% negative tests among CAP patients without a pneumococcal aetiology. However, the test was positive in only 11% of patients with atypical pneumonia and in 4.7% of healthy controls. The positivity rate was higher for NPA ICT compared to culture on NPA in all CAP patients, and to both PCR and culture on NPA in non-pneumococcal non-atypical CAP patients. In 113 (63%) patients with β-lactam monotherapy, cure without treatment alteration was noted more often in cases with positive compared to negative NPA ICT at admission (91% vs 69%; p < 0.01).

CONCLUSIONS: The high sensitivity and the low positivity rates in patients with atypical pneumonia and healthy controls, in combination with the correlation between positive test results and clinical cure with β-lactam therapy, may support a pneumococcal aetiology in CAP in populations with low pneumococcal carriage rates.

Place, publisher, year, edition, pages
2013. Vol. 45, no 6, p. 425-31
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-44372DOI: 10.3109/00365548.2012.760843ISI: 000318940400002PubMedID: 23330980Scopus ID: 2-s2.0-84877917212OAI: oai:DiVA.org:oru-44372DiVA, id: diva2:806938
Note

Funding Agency: Research Committee of Orebro County Council

Available from: 2015-04-22 Created: 2015-04-20 Last updated: 2019-04-24Bibliographically approved
In thesis
1. Detection of polysaccharides and polysaccharide antibodies in pneumococcal pneumonia
Open this publication in new window or tab >>Detection of polysaccharides and polysaccharide antibodies in pneumococcal pneumonia
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro university, 2015. p. 93
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 121
Keywords
Streptococcus pneumoniae, pneumococcus, pneumonia, cellwall polysaccharide, capsular polysaccharide, antibody urinary antigen, nasopharyngeal aspirate, antibody, immunoglobulin, adult
National Category
Microbiology in the medical area
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-43010 (URN)978-91-7529-073-7 (ISBN)
Public defence
2015-05-08, Universitetssjukhuset, Bomanssonsalen, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Note

Funding: Research Committee of Region Orebro County Council

Available from: 2015-02-27 Created: 2015-02-27 Last updated: 2019-04-24Bibliographically approved

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