Kanungo Reba, Bhaskar M, Kumar A, Badrinath S, Rajalakshmi B
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research Pondicherry, India.
Indian J Med Res. 2004 Feb;119(2):75-8.
BACKGROUND & OBJECTIVES: Pneumolysin, a toxin produced by Streptococcus pneumoniae is associated with virulence and is found in all invasive isolates. Its role as a diagnostic tool has recently been exploited. Most of the methods used are based on molecular techniques and are not cost-effective. The present study was undertaken to evaluate a simple, rapid and cost-effective method to detect pneumolysin in CSF as a diagnostic test for pneumococcal meningitis.
A total of 75 CSF samples from children with presumptive diagnosis of acute pyogenic meningitis or encephalitis were subjected to Gram stain, culture and pneumolysin detection by Cowan 1 staphylococcal protein A co-agglutination technique.
Pneumolysin was detected in 26(78.8%) of 33 culture proven CSF samples and 4(9.5%) of 42 culture negative samples. Antigen detection by Co-A had a specificity of 90 per cent and a sensitivity of 79 per cent when compared with culture. Compared to Gram stain, pneumolysin Co-A had a specificity and sensitivity of 91.0 and 92.0 per cent respectively.
INTERPRETATION & CONCLUSION: Detection of pneumolysin was found to be a simple, low cost antigen detection assay for rapid diagnosis of pneumococcal meningitis, for routine use in the developing countries.
肺炎溶血素是肺炎链球菌产生的一种毒素，与毒力相关，存在于所有侵袭性分离株中。其作为诊断工具的作用最近得到了应用。大多数使用的方法基于分子技术，且成本效益不高。本研究旨在评估一种简单、快速且经济高效的方法，用于检测脑脊液中的肺炎溶血素，作为肺炎球菌性脑膜炎的诊断试验。
对75例疑似急性化脓性脑膜炎或脑炎患儿的脑脊液样本进行革兰氏染色、培养，并采用考恩1葡萄球菌蛋白A协同凝集技术检测肺炎溶血素。
在33例培养证实的脑脊液样本中，26例（78.8%）检测到肺炎溶血素；在42例培养阴性样本中，4例（9.5%）检测到肺炎溶血素。与培养相比，协同凝集法检测抗原的特异性为90%，敏感性为79%。与革兰氏染色相比，肺炎溶血素协同凝集法的特异性和敏感性分别为91.0%和92.0%。
检测肺炎溶血素是一种简单、低成本的抗原检测方法，可用于快速诊断肺炎球菌性脑膜炎，适用于发展中国家的常规使用。
