Article
Serological diagnosis of pneumococcal infection in children with pneumonia using protein antigens: A study of cut-offs with positive and negative controls
Registro en:
ANDRADE D. C. et al. Serological diagnosis of pneumococcal infection in children with pneumonia using protein antigens: A study of cut-offs with positive and negative controls. Journal of Immunological Methods, v. 433, p. 31–37, 2016.
0022-1759
/dx.doi.org/10.1016/j.jim.2016.02.021
Autor
Andrade, Dafne Carvalho
Borges, Igor Carmo
Ivaska, Lauri
Peltola, Ville
Meinke, Andreas
Barral, Aldina Maria Prado
Käyhtye, Helena
Ruuskanenb, Olli
Carvalho, Cristiana Maria Nascimento
Resumen
The etiological diagnosis of infection by Streptococcus pneumoniae in children is difficult, and the use of indirect
techniques is frequently warranted.We aimed to study the use of pneumococcal proteins for the serological diagnosis
of pneumococcal infection in children with pneumonia. We analyzed paired serum samples from 13
Brazilian children with invasive pneumococcal pneumonia (positive control group) and 23 Finnish children
with viral pharyngitis (negative control group), all aged b5 years-old. Children with pharyngitis were evaluated
for oropharyngeal colonization, and none of them carried S. pneumoniae.We used a multiplex bead-based assay
with eight proteins: Ply, CbpA, PspA1 and 2, PcpA, PhtD, StkP and PcsB. The optimal cut-off for increase in antibody
level for the diagnosis of pneumococcal infection was determined for each antigen by ROC curve analysis.
The positive control group had a significantly higher rate of ≥2-fold rise in antibody levels against all pneumococcal
proteins, except Ply, compared to the negative controls. The cut-off of ≥2-fold increase in antibody levelswas
accurate for pneumococcal infection diagnosis for all investigated antigens. However, there was a substantial
increase in the accuracy of the test with a cut-off of ≥1.52-fold rise in antibody levels for PcpA. When using the
investigated protein antigens for the diagnosis of pneumococcal infection, the detection of response against at
least one antigen was highly sensitive (92.31%) and specific (91.30%). The use of serology with pneumococcal
proteins is a promising method for the diagnosis of pneumococcal infection in children with pneumonia. The
use of a ≥2-fold increase cut-off is adequate for most pneumococcal proteins.