Likely False-Positive Pneumococcal Antigen Test BinaxNOW Due to Parvimonas micra

Ploton, Marie-Caroline; Caseris, Marion; Jost, Christelle; Picard, Yoann; Gaschignard, Jean; Pierron, Charlotte; Canivez, Suzy; Dalour, Roxanne Le; Bendavid, Michael; Carol, Agnès; Bidet, Philippe; Bonacorsi, Stéphane

doi:10.1016/j.chest.2017.12.026

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Discordance between urinary and pleural fluid favors pleural fluid results when false positives occur. Patients often show a negative urinary antigen test and a positive pleural fluid antigen test confirmed by positive S. pneumoniae cultures [6,7]. In the setting of parapneumonic pleural effusion, as shown in our case, a possible explanation for this is expected higher concentrations of antigen (S. pneumoniae peptidoglycan C-polysaccharide) at the source of the infection when compared to more remote sites like peripheral.…”

Section: Discussionmentioning

confidence: 51%

“…Despite this, false positives for the S. pneumoniae antigen have been documented in patients with viridans streptococcal and certain anaerobic infections [7,8]. The likely mechanism is due to the cross-reactivity of similar cell walls and membrane proteins in different streptococcal species [6].…”

Section: Discussionmentioning

confidence: 99%

“…Identifying a microbial etiology via culture can be slow and non-specific [3,4]. In >60% of empyema cases, plural fluid cultures fail to yield a pathogen [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Discordance of the Urinary and Pleural Fluid Antigen Test and False Positive for Streptococcus pneumoniae in Empyema Secondary to Necrotizing Bacterial Pneumonia

Shumway¹,

Kriege²,

Wood³

2023

Cureus

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Empyema is a severe complication of pneumonia with high morbidity and mortality rates. Rapid diagnosis and tailoring of antibiotic therapy are crucial to treatment success for these severe bacterial lung infections. A Streptococcus pneumoniae (S. pneumonia) antigen test drawn from the pleural fluid rather than a urine sample has been found to have equivalent diagnostic utility to the urinary antigen test. Discordance between these tests is rare.We report a case of a 69-year-old female with CT imaging findings consistent with empyema and a bronchopulmonary fistula. A rapid S. pneumonia antigen test was negative from the urinary sample but positive when drawn from a patient's pleural fluid sample. Final pleural fluid cultures resulted in Streptococcus constellatus (S. constellatus). This case demonstrates discordance between the results of urinary and pleural fluid S. pneumoniae antigen tests, representing a potential pitfall in using rapid antigen testing on pleural fluid samples. False positives for the S. pneumoniae antigen in patients with viridans streptococci infections have been documented due to the cross-reactivity of cell wall proteins in different streptococcal species. Physicians encountering bacterial pneumonia of unknown etiology complicated by empyema should understand the potential for discordance and false positives using this diagnostic method.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Discordance of the Urinary and Pleural Fluid Antigen Test and False Positive for Streptococcus pneumoniae in Empyema Secondary to Necrotizing Bacterial Pneumonia

Shumway¹,

Kriege²,

Wood³

2023

Cureus

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“…The only cross-reactive results in this group were obtained with S. pseudopneumoniae, a species considered to be a respiratory pathogen and having a similar susceptibility profile to antibiotics than S. pneumoniae [17][18][19][20]. Cross-reaction was also observed with P. micra, which was recently reported for another RDT directed against S. pneumoniae [21]; this agent is an anaerobic gram-positive bacterium of the oral microbiota that could be responsible for opportunistic infections of the respiratory area. Second, the sensitivity and NPV of the PneumoResp RDT were excellent with regard to semi-quantitative culture and PCR assays targeting virulence pneumococcal genes, which allowed ruling out all the negative results for S. pneumoniae at day 0 without risk of missing highly positive samples.…”

Section: Discussionmentioning

confidence: 79%

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

et al. 2020

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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 ≥10 7 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.

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Section: Discussionmentioning

confidence: 82%

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

Haddar

Carricajo

et al. 2019

Preprint

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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 ≥ 10 7 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.

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Likely False-Positive Pneumococcal Antigen Test BinaxNOW Due to Parvimonas micra

Cited by 6 publications

References 12 publications

Discordance of the Urinary and Pleural Fluid Antigen Test and False Positive for Streptococcus pneumoniae in Empyema Secondary to Necrotizing Bacterial Pneumonia

Discordance of the Urinary and Pleural Fluid Antigen Test and False Positive for Streptococcus pneumoniae in Empyema Secondary to Necrotizing Bacterial Pneumonia

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

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

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