1. Diagnostic Yield of Pneumococcal Antigen Detection in Cerebrospinal Fluid for Diagnosis of Pneumococcal Meningitis Among Children in China
- Author
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Jue Shen, Yong-Ping Xie, Chun-Zhen Hua, Hong-Jiao Wang, and An-Na Sun
- Subjects
Purulent meningitis ,medicine.medical_specialty ,Adolescent ,Csf culture ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Antigen ,030225 pediatrics ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Child ,Immunoassay ,Antigens, Bacterial ,Bacteriological Techniques ,medicine.diagnostic_test ,Meningitis, Pneumococcal ,business.industry ,Infant, Newborn ,Infant ,Gold standard (test) ,medicine.disease ,Streptococcus pneumoniae ,Pneumococcal antigen ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,business ,Meningitis - Abstract
Objective To determine the diagnostic accuracy of pneumococcal antigen detection in diagnosis of pneumococcal meningitis in children. Methods Purulent meningitis was diagnosed according to European Society for Clinical Microbiology and Infectious Diseases (ESCMID) guideline between July 2014 and June 2016. Along with a cerebrospinal fluid (CSF) culture, pneumococcal antigen detection in cerebrospinal fluid (CSF) was performed, and further identification of pathogens was done with 16S rDNA-PCR and high-throughput sequencing. Results CSF samples collected from 184 children (median age of 1.92 mo). CSF culture was used as the gold standard. 46 (25%) had positive results for culture and 10 (5.4%) were pneumococci; 34 (18.5%) were pneumococcal antigen positive. The sensitivity and specificity of pneumococcal antigen detection were 100% (95% CI: 89.4%-100%) and 86.2% (95% CI: 96.4%-99.9%), respectively. 92.3% (12/13) were confirmed by nucleic acid detection to be pneumococci. Conclusions Pneumococcal antigen detection in CSF has adequate sensitivity and specificity in diagnosing pneumococcal meningitis.
- Published
- 2020