Kanclerski K, Blomquist S, Granström M, Möllby R
National Bacteriological Laboratory, Stockholm, Sweden.
J Clin Microbiol. 1988 Jan;26(1):96-100. doi: 10.1128/jcm.26.1.96-100.1988.
Serum antibodies to purified pneumolysin were determined by enzyme-linked immunosorbent assay (ELISA) in paired samples from 406 adult patients with community-acquired pneumonia and in samples from 184 healthy controls. A high sensitivity (83%) was obtained in patients with blood culture-confirmed pneumococcal pneumonia. In patients with a tentative pneumococcal diagnosis based on culture of samples from the sputum or the nasopharynx, 45% were positive by ELISA. The difference likely reflected the different relevance of cultural findings for the diagnosis of pneumococcal pneumonia. A significant rise in ELISA titer was found in 17% of the patients. When the diagnosis was also based on high titers, 25% were positive. Pneumococcal pneumonia diagnosed by the pneumolysin ELISA was significantly more common in the patients with a more severe disease and who required hospitalization (21 versus 5% for outpatients). Younger patients were more often positive for pneumococci as determined by high titers, while older patients showed titer rises. Mixed infections with other infectious agents were not uncommon. The finding of low titers in acute-phase samples from positive patients and in the youngest and oldest age groups of healthy controls were unexpected, indicating that further studies on the role of pneumolysin in pneumococcal disease are warranted.
采用酶联免疫吸附测定（ELISA）法检测了406例社区获得性肺炎成年患者配对样本及184例健康对照样本中针对纯化肺炎溶血素的血清抗体。血培养确诊的肺炎球菌肺炎患者检测灵敏度较高（83%）。根据痰液或鼻咽样本培养初步诊断为肺炎球菌肺炎的患者中，ELISA检测阳性率为45%。这种差异可能反映了培养结果对于肺炎球菌肺炎诊断的不同相关性。17%的患者ELISA滴度显著升高。若诊断也基于高滴度，则25%的患者呈阳性。通过肺炎溶血素ELISA诊断的肺炎球菌肺炎在病情较重且需要住院治疗的患者中更为常见（住院患者为21%，门诊患者为5%）。年轻患者高滴度检测肺炎球菌阳性更为常见，而老年患者则表现为滴度升高。合并其他感染病原体的混合感染并不少见。在阳性患者急性期样本以及最年轻和最年长健康对照年龄组中发现低滴度，这出乎意料，表明有必要进一步研究肺炎溶血素在肺炎球菌疾病中的作用。
