The Alere BinaxNOW Pneumococcal Urinary Antigen Test: Diagnostic Sensitivity for Adult Pneumococcal Pneumonia and Relationship to Specific Serotypes
The Alere BinaxNOW Pneumococcal Urinary Antigen Test: Diagnostic Sensitivity for Adult Pneumococcal Pneumonia and Relationship to Specific Serotypes
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DOI：
10.1128/jcm.00787-17
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发表时间：
2018-02-01
影响因子：
9.4
通讯作者：
Ardanuy, Carmen
中科院分区：
文献类型：
--
作者：
Shoji, Hisashi;Domenech, Arnau;Ardanuy, Carmen
关于 BinaxNOW 肺炎球菌尿抗原 (PUA) 检测对不同血清型引起的成人肺炎球菌肺炎的敏感性知之甚少。在本研究中，我们旨在分析PUA测试在15年期间（2001年至2015年）的敏感性趋势，并分析其对不同血清型引起的肺炎球菌肺炎的敏感性。我们总共分析了 1,096 个肺炎球菌分离株，这些分离株来自患有肺炎球菌肺炎的成人，这些成人在发病时进行了 PUA 测试。分析了三个时期：2001年至2005年（早期使用七价肺炎球菌结合疫苗[早期PCV7]）、2006年至2010年（晚期PCV7）和2011年至2015年（早期PCV13）。 PUA 测试的敏感性从 2001 年至 2005 年期间的 76.4%（95% 置信区间 [CI]，70.5% 至 82.4%）变化到 2006 年至 2010 年期间的 77.9%（95% CI，74.4% 至 81.4%），并下降至 60.5%（95% CI，55.4% 至 81.4%）。 65.6%），2011 年至 2015 年。这种下降是在 560 个已证实的（2001 年至 2005 年为 83.2%，2006 年至 2010 年为 86.5%，78.1%）和 536 个可能的（2001 年至 2005 年为 70.0%，2006 年至 2010 年为 68.7%）中观察到的。 2010 年和 2011 年至 2015 年分别为 41.5%）肺炎球菌肺炎发作。 PUA 检测诊断某些血清型引起的肺炎的敏感性存在差异，其中 9V (90.6%)、14 (86.8%)、18C (100%) 和 20 (100%) 血清型最高，8 (55.2%)、9L/N (39.1%)、11A 血清型最低(48.8%)、23B (33.3%) 和不可分型 (47.8%) 血清型。与2001年至2005年、2006年至2010年和2011年至2015年相比，血清型9V（分别为3.1%、3.7%和1.7%）和14血清型（分别为7.2%、5.1%和3.1%）的流行率下降，而血清型23B（分别为0%、3.7%和3.1%）的流行率下降。分别增加0.7%和1.4%）、9L/N（分别增加1.0%、1.6%和3.4%）、11A（分别增加2.6%、4.2%和3.7%）和8（分别增加1.5%、1.5%和5.1%）。 PUA 测试敏感性因肺炎球菌肺炎血清型而异，这些差异和血清型分布的变化与 PUA 测试敏感性的总体下降相关。
Little is known about the sensitivity of the BinaxNOW pneumococcal urinary antigen (PUA) test for adult pneumococcal pneumonia caused by different serotypes. In this study, we aimed to analyze the trends in the sensitivity of the PUA test over a 15-year period (2001 to 2015) and to analyze its sensitivity for pneumococcal pneumonia caused by different serotypes. In total, we analyzed 1,096 pneumococcal isolates from adults with pneumococcal pneumonia who had a PUA test performed at the onset of the episode. Three periods were analyzed: 2001 to 2005 (early use of the seven-valent pneumococcal conjugate vaccine [early PCV7]), 2006 to 2010 (late PCV7), and 2011 to 2015 (early PCV13). The sensitivity of the PUA test varied from 76.4% (95% confidence interval [CI], 70.5% to 82.4%) in the period from 2001 to 2005 to 77.9% in 2006 to 2010 (95% CI, 74.4% to 81.4%) and decreased to 60.5% (95% CI, 55.4% to 65.6%) in 2011 to 2015. This decrease was observed in 560 proven (83.2% in 2001 to 2005, 86.5% in 2006 to 2010, and 78.1%) and 536 probable (70.0% in 2001 to 2005, 68.7% in 2006 to 2010, and 41.5% in 2011 to 2015) episodes of pneumococcal pneumonia. Differences were observed in the sensitivity of the PUA test for diagnosing pneumonia caused by certain serotypes, being highest for the 9V (90.6%), 14 (86.8%), 18C (100%), and 20 (100%) serotypes and lowest for the 8 (55.2%), 9L/N (39.1%), 11A (48.8%), 23B (33.3%), and nontypeable (47.8%) serotypes. Comparing 2001 to 2005, 2006 to 2010, and 2011 to 2015, the prevalence of serotypes 9V (3.1%, 3.7%, and 1.7%, respectively) and 14 (7.2%, 5.1%, and 3.1%, respectively) decreased, while the prevalence of serotypes 23B (0%, 0.7%, and 1.4%, respectively), 9L/N (1.0%, 1.6%, and 3.4%, respectively), 11A (2.6%, 4.2%, and 3.7%, respectively), and 8 (1.5%, 1.5%, and 5.1%, respectively) increased. The PUA test sensitivity varied by pneumococcal pneumonia serotype, and these differences and the changes in serotype distribution were associated with an overall decrease in the sensitivity of the PUA test.