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J Med Microbiol 57 (2008), 820-826; DOI: 10.1099/jmm.0.47793-0
© 2008 Society for General Microbiology
ISSN 1473-5644

A novel method for rapid detection of Streptococcus pneumoniae antigen in sputum and its application in adult respiratory tract infections

Naomi Ehara1, Kiyoyasu Fukushima1, Hiroshi Kakeya2, Hiroshi Mukae2, Suguru Akamatsu3, Akiko Kageyama3, Atsushi Saito1 and Shigeru Kohno2

1 Division of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki 859-0497, Japan

2 Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan

3 Otsuka Pharmaceutical Co. Ltd, Tokyo 108-8242, Japan

Correspondence
Kiyoyasu Fukushima
kiyofuku{at}isahaya.jrc.or.jp

Received 3 December 2007
Accepted 8 February 2008

A highly sensitive immunochromatography test kit, ODK0501, was developed using specific polyclonal antibodies against the C-polysaccharide moiety of Streptococcus pneumoniae for the rapid detection of S. pneumoniae antigen in sputum samples. The clinical utility of ODK0501 for this detection was evaluated prospectively in 52 adult patients with respiratory infections and compared with that of a urinary antigen detection kit. Overall, 21 patients (40.4 %) showed positive results with ODK0501, compared with 16 patients (30.8 %) using the urinary antigen detection kit, and S. pneumoniae was cultured from 18 patients. ODK0501 and the urinary antigen detection kit exhibited a sensitivity of 94.4 and 55.6 % (P<0.01), respectively, and a specificity of 88.2 and 82.4 %, respectively. Eleven of thirteen patients with conflicting results between the two test kits exhibited consistent results for sputum cultures. Moreover, eight out of nine patients positive for ODK0501 and negative for the urinary antigen detection kit were S. pneumoniae culture-positive, including five who exhibited phagocytosis, indicating S. pneumoniae as a causative agent of infection, in Gram staining of sputum samples. These results suggest that the ODK0501 direct sputum detection kit is more clinically useful than the urinary antigen detection kit in adult patients with respiratory infections.

Abbreviations: C-ps, C-polysaccharide; NALC, N-acetyl-L-cysteine.






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