Archive for August 10, 2008

Evaluation of Binax NOW, an Assay for the Detection of Pneumococcal Antigen in Urine Samples, Performed among Pediatric Patients

Clinical Infectious Diseases  1 Mar 2001  V.32  N.5  p.824–825

BRIEF REPORT

Scott F. Dowell,1 Robert L. Garman,1 Gang Liu,2 Orin S. Levine,1 and Yong-Hong Yang2

1Respiratory Disease Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta; and 2Beijing Children’s Hospital, Beijing

In our evaluation of a new assay for the detection of pneumococcal antigen in urine (Binax NOW; Binax), the test result was no more likely to be positive among 88 children with radiographically confirmed pneumonia than among 198 control subjects; however, it was significantly more likely to be positive among children who were nasopharyngeal carriers of pneumococci. This test is not likely to be useful for distinguishing children with pneumococcal pneumonia from those who are merely colonized.

abstract
http://www.journals.uchicago.edu/doi/abs/10.1086/319205

PDF
http://www.journals.uchicago.edu/doi/pdf/10.1086/319205

August 10, 2008 at 11:49 pm Leave a comment

Evaluation of the Immunochromatographic Binax NOW Assay for Detection of Streptococcus pneumoniae Urinary Antigen in a Prospective Study of Community-Acquired Pneumonia in Spain

Clinical Infectious Diseases  1 Feb 2003  V.36  N.3  p.286-292

Félix Gutiérrez,1 Mar Masiá,1 J. Carlos Rodríguez,2 Antonio Ayelo,2 Bernardo Soldán,1
Laura Cebrián,2 Carlos Mirete,1 Gloria Royo,2 and Alberto M. Hidalgo1

1Infectious Diseases Unit, Internal Medicine Department, and 2Microbiology Section, Hospital General Universitario de Elche, Alicante, Spain

We evaluated the Binax NOW rapid immunochromatographic membrane test (ICT) for detection of Streptococcus pneumoniae urinary antigen in a population-based prospective study of adults with community-acquired pneumonia (CAP). ICT was performed with urine samples obtained from 452 (91.7%) of 493 patients enrolled. Pneumococcal antigen was detected in 19 (70.4%) of 27 patients with pneumococcal pneumonia. The test results were more frequently positive for patients who had not received antibiotics before testing (26.6% vs. 12.1%;  ). Only 16 (10.3%) of 156 samples obtained from patients with nonpneumococcal pneumonia yielded a positive result. Of the 269 patients who had pneumonia with no pathogen identified, antigen was detected in 69 (25.7%). With conventional microbiological criteria used as the “gold standard,” the test had a sensitivity of 70.4% and a specificity of 89.7%. Testing concentrated urine samples with the ICT may be a useful technique for rapid diagnosis of pneumococcal pneumonia in adults with CAP.
abstract
http://www.journals.uchicago.edu/doi/abs/10.1086/345852

PDF
http://www.journals.uchicago.edu/doi/pdf/10.1086/345852

August 10, 2008 at 11:47 pm Leave a comment

Evaluation of a Rapid Immunochromatographic Test for Detection of Streptococcus pneumoniae Antigen in Urine Samples from Adults with Community-Acquired Pneumonia

Journal of Clinical Microbiology  Oct. 2001  V.39  N.10  p.3495-3498

David R. Murdoch,1,2,* Richard T. R. Laing,3 Graham D. Mills,4 Noel C. Karalus,4 G. Ian Town,3 Stanley Mirrett,2 and L. Barth Reller2

Microbiology Unit, Canterbury Health Laboratories,1 and Christchurch School of Medicine, University of Otago,3 Christchurch, and Waikato Hospital, Hamilton,4 New Zealand, and Clinical Microbiology Laboratory, Duke University Medical Center, Durham, North Carolina 277102

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia but is undoubtedly underdiagnosed. Isolation of S. pneumoniae from blood is specific but lacks sensitivity, while isolation of S. pneumoniae from sputum may represent colonization. We evaluated a new immunochromatographic test (NOW S. pneumoniae urinary antigen test; Binax, Portland, Maine) that is simple to perform and that can detect S. pneumoniae antigen in urine within 15 min. Urine samples from 420 adults with community-acquired pneumonia and 169 control patients who did not have pneumonia were tested. Urine from 315 (75%) of the pneumonia patients and all controls was tested both before and after 25-fold concentration, while the remaining 105 samples were only tested without concentration. S. pneumoniae urinary antigen tests were positive for 120 (29%) patients with pneumonia and for none of the controls. Of the urine samples tested with and without concentration, 96 were positive, of which 6 were positive only after concentration. S. pneumoniae antigen was detected in the urine from 16 of the 20 (80%) patients with blood cultures positive for S. pneumoniae and from 28 of the 54 (52%) patients with sputum cultures positive for S. pneumoniae. The absence of S. pneumoniae antigen in the urine from controls suggests that the specificity is high. Concentration of urine prior to testing resulted in a small increase in yield. The NOW S. pneumoniae urinary antigen test should be a useful adjunct to culture for determining the etiology of community-acquired pneumonia in adults.
abstract
http://jcm.asm.org/cgi/content/abstract/39/10/3495

PDF
http://jcm.asm.org/cgi/reprint/39/10/3495

August 10, 2008 at 11:45 pm Leave a comment

Detection of Streptococcus pneumoniae Antigen by a Rapid Immunochromatographic Assay in Urine Samples*

Chest  Jan 2001  V.119  N.1  p.243-249

José Domínguez, MSc, PhD; Núria Galí, MSc; Silvia Blanco, BSc; Pablo Pedroso, BSc; Cristina Prat, MD; Lurdes Matas, MD, PhD and Vicente Ausina, MD, PhD

* From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Facultat de Medicina de la Universitat Autònoma de Barcelona, Spain.

Study objectives: Evaluation of a newly available rapid (15 min) immunochromatographic membrane test (ICT) to detect Streptococcus pneumoniae in urine samples, in order to assess its utility in the diagnosis of bacteremic and nonbacteremic pneumococcal pneumonia.

Design: Retrospective study.

Setting: We studied urine samples from 51 patients with bacteremic and nonbacteremic pneumonia due to S pneumoniae diagnosed by blood culture and pneumococcal polysaccharide capsular antigen detection by counterimmunoelectrophoresis in urine samples, 16 patients with probable pneumococcal pneumonia, 71 patients with nonpneumococcal pneumonia, and 16 patients with pneumonia but no pathogen identified. Urine samples were collected and frozen at – 20°C until used. The ICT test was performed following the instructions of the manufacturer.

Measurements and results: S pneumoniae antigen was detected in 41 of 51 patients with pneumococcal pneumonia (80.4%); results were positive in 23 of 28 bacteremic cases (82.1%) and in 18 of 23 nonbacteremic cases (78.3%). From patients with a diagnosis of presumptive pneumococcal pneumonia, antigen was detected in seven urine samples (43.7%) and also in one case of the 16 patients with pneumonia but no pathogen identified. The specificity of the ICT test was 97.2%.

Conclusion: The ICT assay is a valuable tool for the diagnosis of pneumococcal pneumonia, especially for the nonbacteremic cases.
abstract
http://www.chestjournal.org/cgi/content/abstract/119/1/243

PDF
http://www.chestjournal.org/cgi/reprint/119/1/243

August 10, 2008 at 11:43 pm Leave a comment

Pneumococcal Septic Arthritis: Review of 190 Cases

Clinical Infectious Diseases 1 Feb 2003  V.36  N.3  p.319-327

John J. Ross,1 Charles L. Saltzman,4 Philip Carling,3 and Daniel S. Shapiro2

1Division of Infectious Diseases, Saint Elizabeth’s Medical Center, and 2Clinical Microbiology and Molecular Diagnostics Laboratory, Boston Medical Center, Boston, and 3Department of Medicine, Carney Hospital, Dorchester, Massachusetts; and 4Department of Orthopedic Surgery, University of Iowa, Iowa City

abstract
http://www.journals.uchicago.edu/doi/abs/10.1086/345954

PDF
http://www.journals.uchicago.edu/doi/pdf/10.1086/345954

August 10, 2008 at 5:47 pm Leave a comment

Rapid bacterial antigen detection is not clinically useful

Journal of Clinical Microbiology  Jun 1995  V.33  N.6  p.1486-1491

MD Perkins, S Mirrett and LB Reller

Clinical Microbiology Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA.

Abstract
Latex agglutination (LA) of capsular polysaccharide bacterial antigen is a frequently performed laboratory procedure, but its use is controversial. To assess the clinical utility of this test, we reviewed all LA tests performed over a 10-month period at two sites, a major university-based referral center and a private specialty pediatric hospital. Samples were assayed either individually or as a panel for the group B streptococcus, Streptococcus pneumoniae, Haemophilus influenzae, and three sets of Neisseria meningitidis serogroups (A and Y, C and W135, and B and Escherichia coli K1). Of 5,169 assays performed on 1,268 clinical samples (786 urine and 478 cerebrospinal fluid, 3 pleural fluid, and 1 synovial fluid sample), 57 (1.1%) were positive, including 1.7% of urine and 0.3% of cerebrospinal fluid samples. All LA true-positive cerebrospinal fluid samples showed the causative microorganisms by Gram stain. Detailed chart review of these 57 positive samples showed that the LA result was false-positive in 31 (54%), true-positive in 22 (38%), and indeterminate in 4 (7%) samples. Therapy was not altered on the basis of any of the true-positive LA results. The 31 false-positive results led to additional cost, prolonged hospitalization, and some clinical complications. Total patient charges were $175,000 ($7,954 per true-positive), with no detectable clinical benefit. Our retrospective study does not support the current use of LA for rapid antigen detection. What, if any, specific indications exist for this test remain to be elucidated. 

abstract
http://jcm.asm.org/cgi/content/abstract/33/6/1486

PDF
http://jcm.asm.org/cgi/reprint/33/6/1486

August 10, 2008 at 5:46 pm Leave a comment


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