Detection and serotyping of pneumococci in community acquired pneumonia patients without culture using blood and urine samples

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• 作者：Karin Elberse ; Suzan van Mens ; Amelieke J Cremers…
• 关键词：Streptococcus pneumoniae ; Pneumococcus ; Community acquired pneumonia ; Detection ; Serotype ; Blood ; Urine
• 刊名：BMC Infectious Diseases
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：425 KB
• 参考文献：1. File TM. Community-acquired pneumonia. Lancet. 2003;362(9400):1991-001. CrossRef
  2. Wunderink RG, Waterer GW. Clinical practice: community-acquired pneumonia. N Engl J Med. 2014;370(6):543-1. CrossRef
  3. Rozenbaum MH, Pechlivanoglou P, van der Werf TS, Lo-Ten-Foe JR, Postma MJ, Hak E. The role of / Streptococcus pneumoniae in community-acquired pneumonia among adults in Europe: a meta-analysis. Eur J Clin Microbiol Infect Dis. 2013;32(3):305-6. CrossRef
  4. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67(1):71-. CrossRef
  5. Esposito S, Bosis S, Colombo R, Carlucci P, Faelli N, Fossali E, et al. Evaluation of rapid assay for detection of / Streptococcus pneumoniae urinary antigen among infants and young children with possible invasive pneumococcal disease. Pediatr Infect Dis J. 2004;23(4):365-. CrossRef
  6. Ishida T, Hashimoto T, Arita M, Tojo Y, Tachibana H, Jinnai M. A 3-year prospective study of a urinary antigen-detection test for / Streptococcus pneumoniae in community-acquired pneumonia: utility and clinical impact on the reported etiology. J Infect Chemother. 2004;10(6):359-3. CrossRef
  7. Lund E. Laboratory diagnosis of Pneumococcus infections. Bull World Health Organ. 1960;23:5-3.
  8. McAvin JC, Reilly PA, Roudabush RM, Barnes WJ, Salmen A, Jackson GW, et al. Sensitive and specific method for rapid identification of / Streptococcus pneumoniae using real-time fluorescence PCR. J Clin Microbiol. 2001;39(10):3446-1. CrossRef
  9. van Mens SP, Meijvis SC, Endeman H, van Velzen-Blad H, Biesma DH, Grutters JC, et al. Longitudinal analysis of pneumococcal antibodies during community-acquired pneumonia reveals a much higher involvement of / Streptococcus pneumoniae than estimated by conventional methods alone. Clin Vaccine Immunol. 2011;18(5):796-01. CrossRef
  10. Pride MW, Huijts SM, Wu K, Souza V, Passador S, Tinder C, et al. Validation of an immunodiagnostic assay for detection of 13 / Streptococcus pneumoniae serotype-specific polysaccharides in human urine. Clin Vaccine Immunol. 2012;19(8):1131-1. CrossRef
  11. Sinclair A, Xie X, Teltscher M, Dendukuri N. Systematic review and meta-analysis of a urine-based pneumococcal antigen test for diagnosis of community-acquired pneumonia caused by / Streptococcus pneumoniae. J Clin Microbiol. 2013;51(7):2303-0. CrossRef
  12. Murdoch DR, Laing RT, Mills GD, Karalus NC, Town GI, Mirrett S, et al. Evaluation of a rapid immunochromatographic test for detection of / Streptococcus pneumoniae antigen in urine samples from adults with community-acquired pneumonia. J Clin Microbiol. 2001;39(10):3495-. CrossRef
  13. Dowell SF, Garman RL, Liu G, Levine OS, Yang YH. Evaluation of Binax NOW, an assay for the detection of pneumococcal antigen in urine samples, performed among pediatric patients. Clin Infect Dis. 2001;32(5):824-. CrossRef
  14. Smith MD, Sheppard CL, Hogan A, Harrison TG, Dance DA, Derrington P, et al. Diagnosis of / Streptococcus pneumoniae infections in adults with bacteremia and community-acquired pneumonia: clinical comparison of pneumococcal PCR and urinary antigen detection. J Clin Microbiol. 2009;47(4):1046-. CrossRef
  15. Millar BC, Xu J, Moore JE. Molecular diagnostics of medically important bacterial infections. Curr Issues Mol Biol. 2007;9(1):21-9. <
• 刊物主题：Infectious Diseases; Parasitology; Medical Microbiology; Tropical Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2334

文摘

Background Treatment of community acquired pneumonia (CAP) patients with antibiotics before laboratory-confirmed diagnosis leads to loss of knowledge on the causative bacterial pathogen. Therefore, an increasing number of pneumococcal infections is identified using non-culture based techniques. However, methods for serotyping directly on the clinical specimen remain scarce. Here we present three approaches for detection and serotyping of pneumococci using samples from patients with CAP. Methods The first approach is quantitative PCR (qPCR) analysis on blood samples (n--11) followed by capsular sequence typing (CST) to identify the serotype. The second approach, a urinary antigen assay (n--23), designated as inhibition multiplex immunoassay (IMIA), is based on Luminex technology targeting 14 serotypes. The third approach is a multiplex immunoassay (MIA) (n--71) also based on Luminex technology which detects serologic antibody responses against 14 serotypes. The three alternative assays were performed on samples obtained from 309 adult hospitalized CAP patients in 2007-010 and the results were compared with those obtained from conventional laboratory methods to detect pneumococcal CAP, i.e. blood cultures, sputum cultures and BinaxNOW? urinary antigen tests. Results Using qPCR, MIA and IMIA, we were able to detect the pneumococcus in samples of 56% more patients compared to conventional methods. Furthermore, we were able to assign a serotype to the infecting pneumococcus from samples of 25% of all CAP patients, using any of the three serotyping methods (CST, IMIA and MIA). Conclusion This study indicates the usefulness of additional molecular methods to conventional laboratory methods for the detection of pneumococcal pneumonia. Direct detection and subsequent serotyping on clinical samples will improve the accuracy of pneumococcal surveillance to monitor vaccine effectiveness.