Nunes Altacílio A, Camargos Paulo A M, Costa Petrônio R, Campos Maria Tereza K
Department of Pediatrics, Medical School, University of Uberaba, Brazil.
Pediatr Pulmonol. 2004 Aug;38(2):135-9. doi: 10.1002/ppul.20044.
Streptococcus pneumoniae and Haemophilus influenzae type b are the main agents of bacterial community-acquired pneumonia in developing countries, although a definite etiologic diagnosis cannot be established in most cases. This study was carried out to assess the performance of a latex particle agglutination test (LPAT) from a commercial kit (Slidex Méningite Kit trade mark, BioMérieux, France) in diagnosing pneumococcal and H. influenzae type b pneumonia. One hundred and seven children (45 ill subjects and 62 healthy controls) were enrolled. All 45 cases had a presumptive diagnosis of bacterial pneumonia based on clinical (WHO criteria), laboratory (white blood cell count > or = 15.000/mm3, polymorphonuclear leukocytes > or = 70%, bands > or = 500/mm3, and C-reactive protein > or = 40 mg/l), and radiological findings, i.e., two or more positive points in the scoring system described by Khamapirad and Glezen (Semin Respir Infect 1987;2:130-144). Clinical, laboratory, and radiological assessments were performed in a blinded manner. LPAT was performed in urine samples after concentration through an ethanol-acetone solution. Sensitivity, specificity, and positive and negative predictive values were 77.3% (95% CI, 61.8-88.0%), 90.3% (95% CI, 79.5-96.0%), 85.0% (95% CI, 69.5-93.8%), and 84.8% (95% CI, 73.4-92.1%), respectively. Results suggest that LPAT is a useful diagnostic tool for the etiologic diagnosis of S. pneumoniae and H. influenzae type b pneumonia, especially in the developing world.
肺炎链球菌和b型流感嗜血杆菌是发展中国家细菌性社区获得性肺炎的主要病原体，尽管在大多数病例中无法确立明确的病因诊断。本研究旨在评估一种市售试剂盒（法国生物梅里埃公司的Slidex Méningite Kit商标）中的乳胶颗粒凝集试验（LPAT）在诊断肺炎球菌和b型流感嗜血杆菌肺炎方面的性能。纳入了107名儿童（45名患病儿童和62名健康对照）。所有45例病例均根据临床（世界卫生组织标准）、实验室检查（白细胞计数≥15000/mm³、多形核白细胞≥70%、杆状核细胞≥500/mm³以及C反应蛋白≥40mg/l）和影像学表现（即Khamapirad和Glezen所描述的评分系统中的两个或更多阳性点，《Semin Respir Infect》1987年；2:130 - 144）初步诊断为细菌性肺炎。临床、实验室和影像学评估均采用盲法进行。通过乙醇 - 丙酮溶液浓缩尿液样本后进行LPAT检测。敏感性、特异性、阳性预测值和阴性预测值分别为77.3%（95%可信区间，61.8 - 88.0%）、90.3%（95%可信区间，79.5 - 96.0%）、85.0%（95%可信区间，69.5 - 93.8%）和84.8%（95%可信区间，73.
