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Comparative Study
. 2020 Apr 7;20(1):79.
doi: 10.1186/s12866-020-01764-0.

Strategy using a new antigenic test for rapid diagnosis of Streptococcus pneumoniae infection in respiratory samples from children consulting at hospital

Cyrille H Haddar  1   2 , Johan Joly  3 , Anne Carricajo  1   3 , Paul O Verhoeven  1   3 , Florence Grattard  1   3 , Olivier Mory  4 , Evelyne Begaud  2 , Yves Germani  2 , Aymeric Cantais  4 , Bruno Pozzetto  5   6
Affiliations
Comparative Study

Strategy using a new antigenic test for rapid diagnosis of Streptococcus pneumoniae infection in respiratory samples from children consulting at hospital

Cyrille H Haddar et al. BMC Microbiol. .

Abstract

Background: Despite vaccination programs, Streptococcus pneumoniae remains among the main microorganisms involved in bacterial pneumonia, notably in terms of severity. The prognosis of pneumococcal infections is conditioned in part by the precocity of the diagnosis. The aim of this study was to evaluate the impact of a Rapid Diagnostic Test (RDT) targeting cell wall polysaccharide of Streptococcus pneumoniae and performed directly in respiratory samples, on the strategy of diagnosis of respiratory pneumococcal infections in children.

Results: Upper-respiratory tract samples from 196 children consulting at hospital for respiratory infection were tested for detecting S. pneumoniae using a newly-designed RDT (PneumoResp, Biospeedia), a semi-quantitative culture and two PCR assays. If positive on fluidized undiluted specimen, the RDT was repeated on 1:100-diluted sample. The RDT was found highly specific when tested on non-S. pneumoniae strains. By comparison to culture and PCR assays, the RDT on undiluted secretions exhibited a sensitivity (Se) and negative predictive value (NPV) of more than 98%. By comparison to criteria of S. pneumoniae pneumonia combining typical symptoms, X-ray image, and culture ≥107 CFU/ml, the Se and NPV of RDT on diluted specimens were 100% in both cases.

Conclusions: In case of negative result, the excellent NPV of RDT on undiluted secretions allows excluding S. pneumoniae pneumonia. In case of positive result, the excellent sensitivity of RDT on diluted secretions for the diagnosis of S. pneumoniae pneumonia allows proposing a suitable antimicrobial treatment at day 0.

Keywords: Child; PCR assay; Pneumonia; Rapid diagnostic test; Respiratory infection; Streptococcus pneumoniae.

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Conflict of interest statement

CHH is a PhD student of the University of Saint-Etienne whose thesis was cofounded by the CIFRE French Ministry of Higher Education and Research (CIFRE fellowship No 1283/2014) and BioSpeedia. EB and YG are working at BioSpeedia. The other authors have no conflict of interest to declare in relation with the matter of this study.

Figures

Fig. 1
Fig. 1
Correlation between qPCR assays and quantitative cultures. The number of cycle threshold (Ct) of two quantitative PCR assays targeting virulence genes of S. pneumoniae was correlated to the number of CFU/ml of S. pneumoniae by conventional culture
Fig. 2
Fig. 2
Correlation between qPCR assays and RDT. The approached quantification using ply (a) or lytA (b) quantitative PCR assays, as evaluated by cycle threshold (Ct), was correlated to the results obtained with the PneumoResp Rapid Diagnostic Test (RDT) on undiluted and diluted respiratory specimens found either negative or positive. The green bar corresponds to the median and the blue bars to the 95% confidence interval. CFU: colony forming unit
Fig. 3
Fig. 3
Distribution of pneumococcal pneumonia according to the RDT result at day 0 in the 196 children of the study. A pneumococcal pneumonia was defined by the presence of an abnormal parenchymal image on chest X-ray and a bacterial load of at least 107 CFU/ml in respiratory secretions. RDT: rapid diagnostic test
Fig. 4
Fig. 4
Proposed strategy based on the PneumoResp RDT for orientating the initial (day 0) anti-pneumococcal treatment of children consulting at hospital for respiratory infection. RDT: rapid diagnostic test
See this image and copyright information in PMC

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