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Pneumococcal antigen detection in bronchoalveolar lavage fluid from patients with pneumonia. 1994

P Jiménez, and M Meneses, and F Saldías, and M Velásquez
Unidad de Enfermedades Respiratorias, Facultad de Medicina, Universidad Austral de Chile.

BACKGROUND Pneumococcal pneumonia can be diagnosed by the detection of capsular antigen in sputum, serum, pleural fluid, or urine using countercurrent immunoelectrophoresis and latex agglutination. In addition, quantitative cultures of bronchoalveolar lavage (BAL) fluid are also reliable for establishing the aetiology of pneumonia. This study investigated the value of rapid detection of pneumococcal antigen in BAL fluid from patients with pneumonia. METHODS Pneumococcal antigen was detected by countercurrent immunoelectrophoresis and latex agglutination. Patients were grouped according to BAL quantitative culture results into pneumococcal pneumonia (n = 24), other known aetiology (n = 18), and unknown aetiology (n = 17). Thirteen patients with interstitial lung disease and without pneumonia served as a control group. RESULTS In patients with pneumococcal pneumonia, antigen was detected by countercurrent immunoelectrophoresis in 50% and by latex agglutination in 54% of cases. In patients with pneumonia of unknown aetiology pneumococcal antigen was detected by latex agglutination in 53% of cases. Antigen was not detected in patients with pneumonia of other known aetiology or in control patients, yielding a specificity of 100%. CONCLUSIONS In patients with pneumococcal pneumonia requiring fibreoptic bronchoscopy detection of pneumococcal antigen in BAL fluid may rapidly and accurately confirm the aetiology. Furthermore, in nearly half the cases of pneumonia of unknown aetiology antigen can be detected, suggesting that Streptococcus pneumoniae is a major causative agent in such patients.

UI MeSH Term Description Entries
D007841 Latex Fixation Tests Passive agglutination tests in which antigen is adsorbed onto latex particles which then clump in the presence of antibody specific for the adsorbed antigen. (From Stedman, 26th ed) Latex Agglutination Tests,Agglutination Test, Latex,Agglutination Tests, Latex,Fixation Test, Latex,Fixation Tests, Latex,Latex Agglutination Test,Latex Fixation Test,Test, Latex Agglutination,Test, Latex Fixation,Tests, Latex Agglutination,Tests, Latex Fixation
D011014 Pneumonia Infection of the lung often accompanied by inflammation. Experimental Lung Inflammation,Lobar Pneumonia,Lung Inflammation,Pneumonia, Lobar,Pneumonitis,Pulmonary Inflammation,Experimental Lung Inflammations,Inflammation, Experimental Lung,Inflammation, Lung,Inflammation, Pulmonary,Inflammations, Lung,Inflammations, Pulmonary,Lobar Pneumonias,Lung Inflammation, Experimental,Lung Inflammations,Lung Inflammations, Experimental,Pneumonias,Pneumonias, Lobar,Pneumonitides,Pulmonary Inflammations
D001992 Bronchoalveolar Lavage Fluid Washing liquid obtained from irrigation of the lung, including the BRONCHI and the PULMONARY ALVEOLI. It is generally used to assess biochemical, inflammatory, or infection status of the lung. Alveolar Lavage Fluid,Bronchial Lavage Fluid,Lung Lavage Fluid,Bronchial Alveolar Lavage Fluid,Lavage Fluid, Bronchial,Lavage Fluid, Lung,Pulmonary Lavage Fluid,Alveolar Lavage Fluids,Bronchial Lavage Fluids,Bronchoalveolar Lavage Fluids,Lavage Fluid, Alveolar,Lavage Fluid, Bronchoalveolar,Lavage Fluid, Pulmonary,Lavage Fluids, Alveolar,Lavage Fluids, Bronchial,Lavage Fluids, Bronchoalveolar,Lavage Fluids, Lung,Lavage Fluids, Pulmonary,Lung Lavage Fluids,Pulmonary Lavage Fluids
D001999 Bronchoscopy Endoscopic examination, therapy or surgery of the bronchi. Bronchoscopic Surgical Procedures,Surgical Procedures, Bronchoscopic,Bronchoscopic Surgery,Surgery, Bronchoscopic,Bronchoscopic Surgeries,Bronchoscopic Surgical Procedure,Bronchoscopies,Surgeries, Bronchoscopic,Surgical Procedure, Bronchoscopic
D003378 Counterimmunoelectrophoresis Immunoelectrophoresis in which immunoprecipitation occurs when antigen at the cathode is caused to migrate in an electric field through a suitable medium of diffusion against a stream of antibody migrating from the anode as a result of endosmotic flow. Electrosyneresis,Immunoelectroosmophoresis,Immunoelectrophoresis, Countercurrent,Immunoelectrophoresis, Crossover,Countercurrent Immunoelectrophoresis,Crossover Immunoelectrophoresis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000942 Antigens, Bacterial Substances elaborated by bacteria that have antigenic activity. Bacterial Antigen,Bacterial Antigens,Antigen, Bacterial
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D013183 Sputum Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus. Sputum, Induced,Induced Sputum,Induced Sputums,Sputums,Sputums, Induced
D013296 Streptococcus pneumoniae A gram-positive organism found in the upper respiratory tract, inflammatory exudates, and various body fluids of normal and/or diseased humans and, rarely, domestic animals. Diplococcus pneumoniae,Pneumococcus

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