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

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)...

Full description

Bibliographic Details
Main Authors:	Moïsi, Jennifer C., Moore, Matthew, da Gloria Carvalho, Maria, Sow, Samba O., Siludjai, Duangkamon, Knoll, Maria Deloria, Tapia, Milagritos, Baggett, Henry C.
Format:	Online
Language:	English
Published:	The American Society of Tropical Medicine and Hygiene 2016
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751951/

id	pubmed-4751951
recordtype	oai_dc
spelling	pubmed-47519512016-02-22 Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study Moïsi, Jennifer C. Moore, Matthew da Gloria Carvalho, Maria Sow, Samba O. Siludjai, Duangkamon Knoll, Maria Deloria Tapia, Milagritos Baggett, Henry C. Articles 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. The American Society of Tropical Medicine and Hygiene 2016-02-03 /pmc/articles/PMC4751951/ /pubmed/26643535 http://dx.doi.org/10.4269/ajtmh.15-0431 Text en ©The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Moïsi, Jennifer C. Moore, Matthew da Gloria Carvalho, Maria Sow, Samba O. Siludjai, Duangkamon Knoll, Maria Deloria Tapia, Milagritos Baggett, Henry C.
spellingShingle	Moïsi, Jennifer C. Moore, Matthew da Gloria Carvalho, Maria Sow, Samba O. Siludjai, Duangkamon Knoll, Maria Deloria Tapia, Milagritos Baggett, Henry C. Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
author_facet	Moïsi, Jennifer C. Moore, Matthew da Gloria Carvalho, Maria Sow, Samba O. Siludjai, Duangkamon Knoll, Maria Deloria Tapia, Milagritos Baggett, Henry C.
author_sort	Moïsi, Jennifer C.
title	Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
title_short	Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
title_full	Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
title_fullStr	Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
title_full_unstemmed	Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study
title_sort	enhanced diagnosis of pneumococcal bacteremia using antigen- and molecular-based tools on blood specimens in mali and thailand: a prospective surveillance study
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.
publisher	The American Society of Tropical Medicine and Hygiene
publishDate	2016
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751951/
_version_	1613537946611220480

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

Similar Items