Abstract:

Streptococcus pneumoniae is a leading cause of meningitis, bacteremia, pneumonia and otitis media in childhood. The diagnosis of pneumococcal infections still remains problematic. Binax NOW® is a rapid immunochromatographic test (ICT) that detects S. pneumoniae C-polysaccharide antigen in the urine. We evaluated the usefulness of ICT in the diagnosis of pneumococcal infections in children in our study. Fifty children with sepsis, pneumonia, otitis or meningitis (patient group) and 50 healthy children (control group) were enrolled in the study. Urine samples and nasopharyngeal cultures were obtained from all cases. Blood, transtracheal aspirate, urine and CSF (cerebrospinal fluid) cultures were also taken from the patient group when possible. We found urinary antigen positivity in 7 cases in the control group and 10 cases in the patient group. All the children who carried S. pneumoniae in their nasopharynx (1 in the control group and 2 in the patient group for a total of 3 cases) had positive ICT. We detected S. pneumoniae in 3 patients (1 blood culture and 2 CSF cultures) and ICT was positive in all. There was no effect of antimicrobial treatment, vaccination and acute phase reactant levels on the urinary antigen detection test. We concluded that this test is not useful in the diagnosis of pneumococcal infections in children as high carrier rates cause false positivity. This test can only be used with other conventional microbiological tests as a supplementary method

Keywords: