AP-HP, Equipe opérationnelle d'Infectiologie, Hôpital Robert-Debré, Paris, France.
AP-HP, Equipe opérationnelle d'Infectiologie, Hôpital Robert-Debré, Paris, France.
Chest. 2018 Apr;153(4):e71-e73. doi: 10.1016/j.chest.2017.12.026.
We retrospectively report four cases from two hospitals of nonpneumococcal pleural empyema with a likely false-positive result on the pneumococcal antigen test BinaxNOW (PATB) (Alere) performed in pleural fluid samples in patients with aspiration pneumonia risk factors. To determine whether the positive reaction was due to cross-reactivity, we separately tested the isolates from the pleural fluid samples, along with collection and reference strains. All patients had polymicrobial aerobic and anaerobic positive cultures, including Parvimonas micra in every case. In all cases, 16S rDNA polymerase chain reaction sequencing yielded Fusobacterium nucleatum. Samples for culture and specific polymerase chain reaction were negative for Streptococcus pneumoniae. We found that the false-positive PATB finding was likely due to P micra, a previously unknown cross-reactivity. In case of aspiration pneumonia risk factors, a positive PATB result must be interpreted with caution because there can be a false positivity due to anaerobic infection or co-infection.
我们回顾了两家医院的 4 例非肺炎链球菌性脓胸病例，这些患者均有发生吸入性肺炎的风险因素，其胸腔积液样本中的 BinaxNOW（PATB）（Alere）肺炎球菌抗原检测结果可能呈假阳性。为了确定阳性反应是否由于交叉反应所致，我们分别测试了胸腔积液样本中的分离株，以及采集株和参考株。所有患者的需氧和厌氧混合培养均为阳性，且每例均有微小消化链球菌。在所有情况下，16S rDNA 聚合酶链反应测序均产生了核梭杆菌。用于培养和特定聚合酶链反应的样本均为肺炎链球菌阴性。我们发现，假阳性 PATB 检测结果可能是由于之前未知的交叉反应的微小消化链球菌所致。在存在发生吸入性肺炎风险因素的情况下，必须谨慎解读阳性 PATB 结果，因为可能由于厌氧菌感染或合并感染而出现假阳性。
