Abstract
The purpose of this investigation was to enhance the detection of pneumococcal bacteremia cases using the Binax NOW® immunochromatographic test (ICT) on blood culture broth as part of surveillance in two rural Thailand provinces. Blood cultures were collected as clinically indicated from hospitalized patients. ICT was performed on broth from culture bottles flagged as positive by BactT/ALERT® (alarm-positive) but which failed to grow organisms on subculture. During the period May 2005–June 2007, ICT was positive on 43 (24%) of 182 alarm-positive blood cultures with no growth on subculture. Compared to pneumococcal bacteremia cases confirmed by culture, cases detected only by ICT had a longer median time from culture collection to incubation and a longer median time from alarm positivity to subculture, and were more likely to be from patients pretreated with antibiotics. In a subsequent surveillance period (July 2007–December 2009), ICT continued to detect additional pneumococcal cases, but in a lower proportion of samples (7 of 221, 3.2%). Recently, as part of a separate study, ICT applied to uninoculated blood culture broth produced weak-positive results, mandating caution if testing broth from patient blood cultures. The antigen testing of blood culture broth appears to enhance the detection of pneumococcal bacteremia, but a controlled evaluation is needed.
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References
Boulware DR, Daley CL, Merrifield C, Hopewell PC, Janoff EN (2007) Rapid diagnosis of pneumococcal pneumonia among HIV-infected adults with urine antigen detection. J Infect 55:300–309
Petti CA, Woods CW, Reller LB (2005) Streptococcus pneumoniae antigen test using positive blood culture bottles as an alternative method to diagnose pneumococcal bacteremia. J Clin Microbiol 43:2510–2512
Baggett HC, Peruski LF, Olsen SJ, Thamthitiwat S, Rhodes J, Dejsirilert S, Wongjindanon W, Dowell SF, Fischer JE, Areerat P, Sornkij D, Jorakate P, Kaewpan A, Prapasiri P, Naorat S, Sangsuk L, Eampokalap B, Moore MR, Carvalho G, Beall B, Ungchusak K, Maloney SA (2009) Incidence of pneumococcal bacteremia requiring hospitalization in rural Thailand. Clin Infect Dis 48(Suppl 2):S65–S74
Perilla MJ, Ajello G, Bopp C, Elliott J, Facklam R (2003) Manual for the laboratory identification and antimicrobial susceptibility testing of bacterial pathogens of public health importance in the developing world. Centers for Disease Control and Prevention (CDC), Atlanta, GA
Rhodes J, Hyder JA, Peruski LF, Fisher C, Jorakate P, Kaewpan A, Dejsirilert S, Thamthitiwat S, Olsen SJ, Dowell SF, Chantra S, Tanwisaid K, Maloney SA, Baggett HC (2010) Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence. Am J Trop Med Hyg 83:301–306
Khoosal MWJ, de Gouveia L, du Plessis M, Manqalaza F, Karstaedt AS, Madhi SA (2005) Usefulness of latex antigen test in improving the sensitivity of detection of pneumococcus from blood culture. In: Program and abstracts of the 1st Joint Congress of the Federation of Infectious Diseases Societies of Southern Africa, Sun City, South Africa, July 2005
Karahan ZC, Mumcuoglu I, Guriz H, Tamer D, Balaban N, Aysev D, Akar N (2006) PCR evaluation of false-positive signals from two automated blood-culture systems. J Med Microbiol 55:53–57
Saha S, Darmstadt G, Naheed A, Arifeen S, Islam M, Fatima K, Breiman R, Sack D, Hamer D (2011) Improving the sensitivity of blood culture for Streptococcus pneumoniae. J Trop Pediatr 57:192–196
Acknowledgments
For their contributions to this work, we acknowledge Sathapana Naorat, Prabda Prapasiri, Sununta Henchaichon, Prasong Srisaengchai, Thantapat Akarachotpong, Puangtong Tungpruchayakul, Pornpak Khunatorn, Pattraporn Klanjatturat, and Wanna Wongjindanon from the International Emerging Infections Program; Denchai Sornkij, Nakhon Phanom Provincial Health Office; Peera Areerat, Sa Kaeo Provincial Health Office; and Pokasem Sirinarm and Pichai Thongtaradol from the Thailand Ministry of Public Health. Thanks go to Scott Dowell, Karen Miernyk, and Matt Moore from the U.S. Centers for Disease Control and Prevention (CDC) for their technical input. Support for this project was provided by the CDC Foundation and the Pneumococcal vaccines Accelerated Development and Introduction Plan (PneumoADIP), which was funded by the GAVI Alliance and is based at the Johns Hopkins Bloomberg School of Public Health.
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Baggett, H.C., Rhodes, J., Dejsirilert, S. et al. Pneumococcal antigen testing of blood culture broth to enhance the detection of Streptococcus pneumoniae bacteremia. Eur J Clin Microbiol Infect Dis 31, 753–756 (2012). https://doi.org/10.1007/s10096-011-1370-3
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DOI: https://doi.org/10.1007/s10096-011-1370-3