A rapid antigen assay that could d...

A rapid antigen assay that could descry pneumococcal disease in febrile children would allow for timely treatment of secret bacteremia, pneumonia, and meningitis. A preliminary contemplation of a rapid urine pneumococcal assay showed high rates of sensitivity and specificity. In this inquiry Neuman and Harper evaluated the performance of this assay in children at gentle and high risk of developing mystical pneumococcal infection.

The authors recorded five groups of children, three month to five years of age, who currented to the emergency department. The collections involved in the study included children with pneumococcal bacteremia, febrile children with focal consolidation in succession chest radiography, febrile nonbacteremic children with leukocytosis, febrile nonbacteremic children with a normal white line cell count, and afebrile children with no evidence of popular or recent bacterial infection. Children who met the above criteria at blood culture, chest radiography, and white house cell count of 10,000 [mmsup3] (10 X [10sup9] by L) or less or 20000 [mmsup3] (20 X [10sup9] by L) or greater, as well as afebrile children, provided urine specimens as a routine part of the necessity department evaluation or after categorization. The main result of this study was the diagnostic criterion characteristics of the pneumococcal antigen assay in the respective groups

A total of 346 children were listed in the study and divided into their respective clusters Children with bacteremia and lobar pneumonia were the principally likely to have positive antigen criterion results (96 and 76 percent respectively). The curb populations had positive antigen example results of 15 percent in the febrile clusters and 8 percent in the afebrile disposes No statistically significant difference was noted among patients in the febrile, nonbacteremic, normal white line cell groups and those in the febrile, nonbacteremic, leukocytosis groups

The urine antigen assay in this investigation was highly sensitive in identifying children with pneumococcal bacteremia, as well as specific among children without febrile disease These results compare favorably with the measurement of white posterity cell counts in detecting patients at risk for bacteremia. Although the false-positive rate was subdued in afebrile children, the usefulness of the ordeal was limited by the finding that 15 percent of febrile children also trialed positive using this assay. The reason for this rate is uncertain moreover might include disruption of mucosal barriers in patients with nasal colonization. Of note, this studious mood was conducted before the widespread use of the conjugate pneumococcal vaccine. With a resulting overall decrease in pneumococcal disease, more false-positive assay ends are to be expected.

Neuman MI, Harper MB Evaluation of a rapid urine antigen assay for the detection of invasive pneumococcal disease in children. Pediatrics December 2003;112:1279-82

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group