Laboratory-based diagnosis of pneumococcal pneumonia: state of the art and unmet needs
| Autor: | Keith P. Klugman, Catherine Satzke, G. Vernet, J.-F. Maisonneuve, Samir K. Saha, Deborah C. Hay Burgess, M.C. Steinhoff, Bernard Beall, Mark R. Alderson |
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| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty diagnosis detection Disease medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Community-acquired pneumonia Conjugate vaccine Streptococcus pneumoniae Epidemiology Medicine 030212 general & internal medicine Intensive care medicine 0303 health sciences 030306 microbiology business.industry Pneumococcal pneumonia General Medicine Vaccine efficacy medicine.disease serotyping 6. Clean water 3. Good health pneumococci Pneumonia Infectious Diseases Immunology business |
| Zdroj: | Clinical Microbiology and Infection. 17:1-13 |
| ISSN: | 1198-743X |
| DOI: | 10.1111/j.1469-0691.2011.03496.x |
| Popis: | In view of the increasing use of pneumococcal vaccines, especially in the developing world, there is a need for appropriate diagnostics to understand the aetiology of pneumonia, to define the burden of pneumococcal disease, and to monitor vaccine efficacy and effectiveness. This article summarizes a meeting on the diagnosis, detection and serotyping of pneumococcal disease organized by PATH and Fondation Mérieux (18–20 October 2009, Fondation Mérieux Conference Centre, Les Pensières, France). Workers and experts met to discuss the gaps in the microbiology-based diagnosis of Streptococcus pneumoniae disease, with special emphasis on pneumonia. The meeting was designed to evaluate the state of the art of pneumococcal diagnostics and serotyping methodologies, identify research and development needs, and propose new guidelines to public health authorities to support the introduction of vaccines. Regarding detection, the main recommendations were to encourage chest X-rays and antigen detection in urine. Large-scale studies are needed to evaluate the diagnostic utility of test algorithms that associate chest X-rays, antigen detection in urine, S. pneumoniae quantitative PCR in nasopharyngeal aspirates and sputum, and C-reactive protein or procalcitonin measurement in blood. Efforts should be focused on proteomics to identify pneumococcus-specific antigens in urine or host markers in blood expressed during pneumonia. It was recommended to develop S. pneumoniae typing capacities, to understand the epidemiology of pneumococcal disease, and to evaluate vaccine effectiveness. Simple and effective approaches are encouraged, and new technologies based on beads, microarrays or deep sequencing should be developed to determine, in a single test capsular serotype, resistance profile and genotype. |
| Databáze: | OpenAIRE |
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