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Evaluation of the Sofia S. pneumoniae FIA for Detection of Pneumococcal Antigen in Patients with Bloodstream Infection
Örebro University, School of Medical Sciences.
Department of Clinical Microbiology F 72, Karolinska University Hospital Huddinge, Stockholm, Sweden; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Department of Infectious Diseases.ORCID iD: 0000-0002-8730-6955
2019 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 57, no 8, article id UNSP e01535-18Article in journal (Refereed) Published
Abstract [en]

The usefulness of pneumococcal urinary antigen tests (UATs) in severe pneumococcal infection relies heavily on the performance in bacteremic patients. Fluorescence technology and automatic reading of test results may improve UAT performance. We evaluated the automatically read Sofia S. pneumoniae FIA for diagnosing pneumococcal bloodstream infection (BSI) in hospitalized adult patients. First, the Sofia FIA was evaluated on 97 patients with pneumococcal (n = 47) and nonpneumococcal (n = 50) BSI and compared with results by the visually read BinaxNOW S. pneumoniae immunochromatographic test (ICT) and ImmuView S. pneumoniae and Legionella pneumophila ICT. In four cases (4.1%), the Sofia FIA showed invalid test results, three of which showed invalid results by the ImmuView ICT previously. Based on 93 valid cases, the Sofia FIA showed similar sensitivity (for both comparisons: 68% versus 62%; P = 0.45) and specificity (for both comparisons: 91% versus 93%; P = 1.00) as the visually read UATs. Second, the Sofia FIA was prospectively evaluated on 82 consecutive nonfrozen urine samples, detecting pneumococcal antigen in 10 of 14 (sensitivity, 71%) pneumococcal BSI patients, similarly to the visually and automatically read BinaxNOW ICT (both 12 of 14; sensitivity, 86%; P = 0.50). Of five nonpneumococcal BSI cases, the Sofia FIA showed an invalid test result in one case, but no positive UAT results were obtained. Thus, the sensitivity and specificity of the Sofia FIA were similar to the performance rates of other UATs in patients with BSI, but invalid test results are of concern for the usefulness in pneumococcal BSI.

Place, publisher, year, edition, pages
American Society for Microbiology , 2019. Vol. 57, no 8, article id UNSP e01535-18
Keywords [en]
Streptococcus pneumoniae, antigen specificity, community-acquired infections, pneumococcus, pneumonia, urinary antigen test
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-75709DOI: 10.1128/JCM.01535-18ISI: 000477738500030PubMedID: 31118270Scopus ID: 2-s2.0-85069916244OAI: oai:DiVA.org:oru-75709DiVA, id: diva2:1342763
Note

Funding Agency:

Region Örebro County Council Research Committee  OLL-723721

Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-08-14Bibliographically approved

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Olofsson, EmmaAthlin, Simon

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