Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study

Details

• Alternative Title:
  Am J Trop Med Hyg
• Personal Author:
  Moïsi, Jennifer C. ; Moore, Matthew ; da Gloria Carvalho, Maria ; Sow, Samba O. ; Siludjai, Duangkamon ; Knoll, Maria Deloria ; Tapia, Milagritos ; Baggett, Henry C.
• Corporate Authors:
  Laboratory Evaluation of Assays for Pneumococcus (LEAP) Study Investigators
• Description:
  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.
• Subjects:
  Adolescent Adult Aged Antigens, Bacterial Bacteremia Bacteriological Techniques Child Child, Preschool Female Humans Infant Male Meningitis, Pneumococcal Middle Aged Pneumococcal Infections Pneumonia, Pneumococcal Population Surveillance Prospective Studies Streptococcus Pneumoniae Young Adult

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• Source:
  Am J Trop Med Hyg. 2016; 94(2):267-275.
• Pubmed ID:
  26643535
• Pubmed Central ID:
  PMC4751951
• Document Type:
  Journal Article
• Place as Subject:
  Mali ; Thailand
• Volume:
  94
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d741c099a9608bc8e902e8cfeeb95e3a7f779f103ce53a41b15be2ad6c5a24f4
• Download URL:
  https://stacks.cdc.gov/view/cdc/38212/cdc_38212_DS1.pdf
• File Type:
  [PDF - 558.05 KB ]