Rapid urinary antigen test (Binax NOW) for diagnosis of S. pneumonia in children with upper and lower respiratory tract infections

Abstract

Abstract. To compare the prevalence of Streptococcus pneumoniae by rapid urinary test and blood culture in children with respiratory tract infection and healthy children (controls).  Pneumococcal antigenuria was detected in 31.5 % of CAP, 31.5 % of rhinosinusitis cases and 6 % of controls. Pneumococcal antigenuria was significantly more frequently detected in both CAP and rhinosinusitis cases than controls (Fishers exact test; CI 95%, p = 0.01). In no cases of non pneumococcal CAP was antigenuria detected. Compared with blood culture, the specificity of the Pneumococcal antigenuria test was 94%. Nasopharyngeal carrier states for S.pneumoniae in healthy control are very low (6%). We recommend the rapid urinary antigen test to conventional cultural methods for early diagnosis of   pneumococcal respiratory infection as a basis for starting appropriate treatment.This study help to inform policy making for the mass infant immunization with PCV7 in our country to decrease incidence of invasive pneumococcal disease.

Key words: Streptococcus pneumonia, rapid immunochromatographic test, acute rhinosinusitis, community-acquired pneumonia, nasopharyngeal carriers.

Keywords

• Streptococcus pneumonia, rapid immunochromatographic test, acute rhinosinusitis, communityacquired pneumonia, nasopharyngeal carriers

Kaynakça

1. 1. Epidemiology Reference Group. Global estimate of the incidence of clinical pneumonia among children under five years of age. WHO 2004; 82: 895-903.
2. 2. Wardlaw T, Salama P, Johansson EW, Mason E. Pneumonia: the leading killer of children. Lancet 2006; 368: 1048-1050.
3. 3. Diane E, Pappa SJ, Dwien H. Sinusitis in Nelson Textbook of Pediatrics;18th edition. Philadelphia Saunders 2007; 1751-1752.
4. 4. Nelson JD. Community-acquired pneumonia in children: guidelines for treatment. Pediatr Infect Dis J 2000; 19: 251-253.
5. 5. Juvén T, Mertsola J, Waris M, et al. Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J 2000; 19: 293-298.
6. 6. American Academy of Pediatrics, Subcommittee on Management of Sinusitis and Committee on Quality Improvement: Clinical practice guideline: Management of sinusitis. Pediatrics 2001; 108: 798-808.
7. 7. Germiller JA, Monin DL, Sparano AM, Tom LW. Intracranial complications of sinusitis in children and adolescents and their outcomes. Arch Otolaryngol Head Neck Surg 2006; 132: 969-976.
8. 8. Goldsmith AJ, Rosenfeld RM. Treatment of pediatric sinusitis. Pediatr Clin North Am 2003; 50: 413-426.

9. 9. Kaplan SL. Review of antibiotic resistance, antibiotic treatment and prevention of pneumococcal pneumonia. Paediatr Respir Rev 2004; 5: 153-158.
10. 10. Jacobs MR. Worldwide trends in antimicrobial resistance among common respiratory tract pathogens in children. Pediatr Infect Dis J 2003; 22: 109-119.
11. 11. Grijalva CG, Poehling KA, Nuorti JP, et al. National impact of universal childhood immunization with pneumococcal conjugate vaccine on outpatient medical care visits in the United States. Pediatrics 2006; 118: 865-873.
12. 12. Tarragó D, Casal J, Ruiz-Contreras J, et al. Assessment of antibody response elicited by a 7- valent pneumococcal conjugate vaccine in pediatric human immunodeficiency virus infection. Clin Diagn Lab Immunol 2005; 12: 165-170.
13. 13. Sato N, Takayanagi N, Kurashima K, et al. Usefulness of Streptococcus pneumoniae urinary antigen detection kit and the duration and intensity of reactivity with urinary antigen in patients with pneumonia. Nihon Kokyuki Gakkai Zasshi 2004; 42: 247-252.
14. 14. Gutiérrez F, Masiá M, Rodríguez JC, et al. Evaluation of the immunochromatographic Binax NOW assay for detection of Streptococcus pneumoniae urinary antigen in a prospective study of community-acquired pneumonia in Spain. Clin Infect Dis 2003; 36: 286-292.
15. 15. Hamer DH, Egas J, Estrella B, et al. Assessment of the Binax NOW Streptococcus pneumoniae urinary antigen test in children with nasopharyngeal pneumococcal carriage. Clin Infect Dis 2002; 34: 1025-1028.
16. 16. Weatherall C, Paoloni R, Gottlieb T. Point-of-care urinary pneumococcal antigen test in the emergency department for community acquired pneumonia. Emerg Med J 2008; 25: 144-148.
17. 17. Porcel JM, Ruiz-González A, Falguera M, et al. Contribution of a pleural antigen assay (Binax NOW) to the diagnosis of pneumococcal pneumonia. Chest 2007; 131: 1442-1447.
18. 18. Ishida T, Hashimoto T, Arita M, et al. A 3-year prospective study of a urinary antigen-detection test for Streptococcus pneumoniae in communityacquired pneumonia: utility and clinical impact on the reported etiology. J Infect Chemother 2004; 10: 359-363.
19. 19. Kobashi Y, Yoshida K, Miyashita N, Niki Y, Matsushima T. Evaluating the use of a Streptococcus pneumoniae urinary antigen detection kit for the management of communityacquired pneumonia in Japan. Respiration 2007; 74: 387-393.
20. 20. Noorbakhsh S, Arzpeima S, Shenasa M, Rafinejad M. Determination the penicillin resistant pneumococcal colonization rate in day care center children. The Journal of Iranian Medical University 2000; 27: 9-12.
21. 21. Bakhshaei M, Ghazvini K, Naderi HR, et al. The prevalence of nasopharyngeal streptococcal pneumonia carriers in mashhad day care children and their antibiotic resistance pattern the Iranian Journal of Otorhinolaryngology 2006; 45: 119- 126.
22. 22. Khotayi Q, Ashtiani MT, Makki N, Shekarabi D. Pneumococcal nasopharyngeal colonization during the first days of antibiotic treatment in pediatric patients. Iranian Journal of Pediatrics 2002; 12: 45-48.
23. 23. Noorbakhsh S, Siadati SA, Rimaz S, Mamishi S, Haghi Ashtiani T. Determination Of Appropriate Antibiotic In Bacterial Meningitis Of Children Based On MIC. Tehran University Medical Journal (TUMJ) 2005; 63: 68-76.
24. 24. Fahimzad AR, Mamaishi S, Noorbakhsh S, et al. Study of antibiotics resistance in pediatric acute bacterial meningitis with E-Test method. Iranian Journal of Pediatrics 2006; 16: 149-156.
25. 25. Noorbakhsh S, Farhadi M, Tabatabaei A, Ghafari M. Serum immunoglobulins in children with rhinosinusitis. Med Lab Jou 2008; 1: 43-49.