Pleural effusion with negative culture: a challenge for pneumococcal diagnosis in children.

Abstract:

BACKGROUND:Pneumococcal parapneumonic effusion seems to be increasing in children in the postvaccine era and is frequently associated with negative culture. Due to the low yield of culture, culture-independent tools are evaluated. METHODS:Culture-negative pleural fluid specimens from 38 children with parapneumonic effusion were examined for pneumococcal lytA by quantitative polymerase chain reaction (qPCR) and soluble antigen (C-polysaccharide) using an immunochromatographic test (BinaxNow Streptococcus pneumoniae). RESULTS:In 81% (30/37) and 63% (24/38) of the specimens, a positive result was obtained by qPCR and antigen detection, respectively. Most mismatches were observed in specimens with low quantities of pneumococcal DNA and a negative antigen test. CONCLUSIONS:Our results suggest an imperfect relationship between the 2 described methods. The immunochromatographic assay is a simple diagnostic tool, which can be used when resources are limited, and even after antibiotic use, but negative results may require confirmation through a more sensitive test, such as qPCR.

authors

Perez VP,Caierão J,Fischer GB,Dias CA,d'Azevedo PA

doi

10.1016/j.diagmicrobio.2016.07.022

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

200-4

issue

2

eissn

0732-8893

issn

1879-0070

pii

S0732-8893(16)30230-9

journal_volume

86

pub_type

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