社区获得性肺炎患儿与非社区获得性肺炎患儿的尿肺炎球菌血清型检测

Urinary pneumococcal serotype detection among children with and without community-acquired pneumonia.

作者信息

Ambroggio Lilliam, Grant Lindsay R, Cotter Jillian M, Dominguez Samuel R, Olson Daniel, Saporta-Keating Sara R, Bender Cody, Ali Mohammad, Grice Kathleen, Lerner Gonzalo, Pride Michael W, Miller Ashley, Tort Maria J, Vaughan Annaellis, Temte Elizabeth, Edid Alec, Cané Alejandro, Hulten Kristina G, Stein Jill, Gessner Bradford D, Asturias Edwin J

机构信息

Section of Emergency Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA.

Section of Hospital Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA.

出版信息

BMC Infect Dis. 2025 Aug 7;25(1):995. doi: 10.1186/s12879-025-11384-6.

DOI:10.1186/s12879-025-11384-6

PMID:40775748

Abstract

BACKGROUND

Urinary antigen detection (UAD) assays can address diagnostic challenges with culture-based identification of S. pneumoniae. We aimed to evaluate the utility of Pfizer's UAD1 and UAD2 assays for pneumococcal serotype surveillance in children with community acquired pneumonia (CAP) or upper respiratory tract infections (URI).

METHODS

From March 2021-December 2023, children 3 months to 5 years who presented to the Children's Hospital Colorado Emergency Department with respiratory symptoms were enrolled as CAP or URI; healthy children served as controls. Nasal swabs were tested for pneumococcus by PCR. UAD assays identified pneumococcal serotypes from urine. Groups were compared using descriptive statistics.

RESULTS

We enrolled 407 controls, 202 with URI, and 280 with CAP. Positivity thresholds were set for all UAD serotypes. Pneumococcal nasal swab positivity was 23% for CAP, 17% for URI, and 3% in controls. Serotypes 3, 15B/C, 19 F, and 35B were frequent in nasal swabs in children with CAP or URI. UAD identified serotypes in 13% with CAP and 5% with URI. The most common urine serotypes were 19 F, 22 F, and 9 N. Among children with a nasal swab collected, 28/190 (15%) with CAP and 4/135 (3%) with URI had a positive UAD; 7 (3.7%) and 2 (1.5%), respectively, were the same serotype identified by nasal swab.

CONCLUSIONS

UAD may be useful in differentiating pneumococcal serotypes in children with CAP and URI from controls. For most, serotypes identified in nasal swabs were not those identified by UAD suggesting UAD positivity was not due to pneumococcal carriage. The Pfizer UAD assay could be utilized for population monitoring of serotype distribution among children with CAP.

摘要

背景

尿抗原检测（UAD）试验可应对基于培养法鉴定肺炎链球菌时面临的诊断挑战。我们旨在评估辉瑞公司的UAD1和UAD2试验在社区获得性肺炎（CAP）或上呼吸道感染（URI）儿童肺炎球菌血清型监测中的效用。

方法

2021年3月至2023年12月，科罗拉多州儿童医院急诊科出现呼吸道症状的3个月至5岁儿童被纳入CAP或URI组；健康儿童作为对照组。通过聚合酶链反应（PCR）检测鼻拭子中的肺炎球菌。UAD试验从尿液中鉴定肺炎球菌血清型。使用描述性统计对各组进行比较。

结果

我们纳入了407名对照组儿童、202名URI儿童和280名CAP儿童。为所有UAD血清型设定了阳性阈值。CAP儿童肺炎球菌鼻拭子阳性率为23%，URI儿童为17%，对照组为3%。3型、15B/C型、19F型和35B型在CAP或URI儿童的鼻拭子中较为常见。UAD在13%的CAP儿童和5%的URI儿童中鉴定出血清型。最常见的尿液血清型为19F型、22F型和9N型。在采集了鼻拭子的儿童中，28/190（15%）的CAP儿童和4/135（3%）的URI儿童UAD呈阳性；分别有7名（3.7%）和2名（1.5%）与鼻拭子鉴定的血清型相同。