Ramsey B W, Marcuse E K, Foy H M, Cooney M K, Allan I, Brewer D, Smith A L
Pediatrics. 1986 Jul;78(1):1-9.
Two immunochemical methods were used to identify Haemophilus influenzae and Streptococcus pneumoniae capsular antigens in the urine and serum of 162 children with acute lower respiratory tract infection. These methods were compared with standard bacterial blood culture. Viral and mycoplasma cultures of respiratory secretions were obtained simultaneously to determine the frequency of antigenuria at the time of nonbacterial acute lower respiratory tract infection. Urine from groups of well children and children with acute otitis media was tested for capsular antigens to determine the incidence of antigenuria. Antigenuria was found in 24% of children 2 months to 18 years of age with acute lower respiratory tract infection compared with a 2% incidence of bacteremia. Antigenuria was found in 4% of asymptomatic children and 16% of children with acute otitis media. One third of children with symptoms of acute lower respiratory tract infection and viral isolates from the oropharynx had bacterial antigenuria. The sixfold increase in frequency of bacterial antigenuria in children at the time of lower respiratory symptoms suggests that bacterial acute lower respiratory tract infection may be more common than identified by traditional culture techniques. Because bacterial antigen may come from other sites such as the middle ear, further studies are needed to determine the role of antigen detection in the diagnosis of pediatric acute lower respiratory tract infection.
采用两种免疫化学方法对162例急性下呼吸道感染儿童的尿液和血清中的流感嗜血杆菌及肺炎链球菌荚膜抗原进行鉴定。将这些方法与标准细菌血培养进行比较。同时获取呼吸道分泌物的病毒和支原体培养物，以确定非细菌性急性下呼吸道感染时抗原尿的发生率。检测健康儿童组及急性中耳炎儿童的尿液中的荚膜抗原，以确定抗原尿的发生率。在2个月至18岁的急性下呼吸道感染儿童中，24%发现有抗原尿，而菌血症的发生率为2%。在无症状儿童中，4%发现有抗原尿，在急性中耳炎儿童中，16%发现有抗原尿。有急性下呼吸道感染症状且口咽部分离出病毒的儿童中，三分之一有细菌抗原尿。下呼吸道症状出现时儿童细菌抗原尿发生率增加了6倍，这表明细菌性急性下呼吸道感染可能比传统培养技术所确定的更为常见。由于细菌抗原可能来自中耳等其他部位，因此需要进一步研究以确定抗原检测在小儿急性下呼吸道感染诊断中的作用。
