Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
Autor: | Jennifer C, Moïsi, Matthew, Moore, Maria da Gloria, Carvalho, Samba O, Sow, Duangkamon, Siludjai, Maria Deloria, Knoll, Milagritos, Tapia, Henry C, Baggett, The Laboratory Evaluation Of Assays For Pneumococcus Leap Study Investigators |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male 0301 basic medicine Adolescent 030106 microbiology Bacteremia Blood volume Mali medicine.disease_cause Pneumococcal Infections Microbiology law.invention Young Adult 03 medical and health sciences law Virology parasitic diseases Streptococcus pneumoniae medicine Humans Blood culture Prospective Studies Child Polymerase chain reaction Aged Whole blood Antigens Bacterial Bacteriological Techniques medicine.diagnostic_test Meningitis Pneumococcal business.industry Infant Articles Middle Aged Pneumonia Pneumococcal Thailand medicine.disease Pneumococcal infections Infectious Diseases Child Preschool Population Surveillance Immunology Female Parasitology business Meningitis |
Zdroj: | The American Journal of Tropical Medicine and Hygiene |
ISSN: | 1476-1645 0002-9637 |
Popis: | Prior antibiotic use, contamination, limited blood volume, and processing delays reduce yield of blood cultures for detection of Streptococcus pneumoniae. We performed immunochromatographic testing (ICT) on broth from incubated blood culture bottles and real-time lytA polymerase chain reaction (PCR) on broth and whole blood and compared findings to blood culture in patients with suspected bacteremia. We selected 383 patients in Mali and 586 patients in Thailand based on their blood culture results: 75 and 31 were positive for pneumococcus, 100 and 162 were positive for other pathogens, and 208 and 403 were blood culture negative, respectively. ICT and PCR of blood culture broth were at least 87% sensitive and 97% specific compared with blood culture; whole blood PCR was 75–88% sensitive and 96–100% specific. Pneumococcal yields in children < 5 years of age increased from 2.9% to 10.7% in Mali with > 99% of additional cases detected by whole blood PCR, and from 0.07% to 5.1% in Thailand with two-thirds of additional cases identified by ICT. Compared with blood culture, ICT and lytA PCR on cultured broth were highly sensitive and specific but their ability to improve pneumococcal identification varied by site. Further studies of these tools are needed before widespread implementation. |
Databáze: | OpenAIRE |
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