{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:03:24Z","timestamp":1790679804590,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001125","name":"GAVI Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["201588766"],"award-info":[{"award-number":["201588766"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["201233523"],"award-info":[{"award-number":["201233523"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["201022732"],"award-info":[{"award-number":["201022732"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["200749550"],"award-info":[{"award-number":["200749550"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["201686542"],"award-info":[{"award-number":["201686542"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["202048618"],"award-info":[{"award-number":["202048618"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["202048971"],"award-info":[{"award-number":["202048971"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sensitivity of culture for the detection of Streptococcus pneumoniae is limited by prior antibiotic exposure. Immunochromatographic test (ICT) is highly sensitive and specific for pneumococcal antigen detection in the cerebrospinal fluid (CSF) of meningitis cases. We determined the specificity and sensitivity of culture, ICT, and polymerase chain reaction (PCR) and the effect of antibiotic exposure on their performance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>CSF specimens from suspected meningitis cases admitted to Dhaka Shishu Hospital, Bangladesh, were tested using culture, ICT and PCR. Additionally, 165 specimens collected from 69 pneumococcal cases after antibiotic treatment were tested.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1883 specimens tested, culture detected 9, quantitative PCR (qPCR) detected 184, and ICT detected 207 pneumococcal cases (including all culture and qPCR positives). In comparison to ICT, sensitivity of culture was 4.4% and of qPCR was 90.6%; both were 100% specific. After antibiotic exposure, culture sensitivity plummeted rapidly; conventional PCR and qPCR sensitivity disappeared after day 6 and 20, respectively. ICT detected pneumococcal antigen for &amp;gt;10 weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While culture provides the most information about bacterial characteristics, in high antibiotic exposure settings, ICT exhibits maximum sensitivity. We recommend culture and ICT as mainstay for pneumococcal diagnosis and surveillance; qPCR can generate additional molecular data where possible.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab073","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T13:29:14Z","timestamp":1612531754000},"page":"S209-S217","source":"Crossref","is-referenced-by-count":17,"title":["Comparison of Culture, Antigen Test, and Polymerase Chain Reaction for Pneumococcal Detection in Cerebrospinal Fluid of Children"],"prefix":"10.1093","volume":"224","author":[{"given":"Md","family":"Hasanuzzaman","sequence":"first","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"},{"name":"Microbiology Program, Department of Mathematics and Natural Sciences, Brac University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6087-6766","authenticated-orcid":false,"given":"Senjuti","family":"Saha","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roly","family":"Malaker","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafizur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad S I","family":"Sajib","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajib C","family":"Das","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maksuda","family":"Islam","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davidson H","family":"Hamer","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA"},{"name":"Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA"},{"name":"National Emerging Infectious Disease Laboratory, Boston University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary L","family":"Darmstadt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3820-0748","authenticated-orcid":false,"given":"Samir K","family":"Saha","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Dhaka, Bangladesh"},{"name":"Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh"},{"name":"Bangladesh Institute of Child Health, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"2021090116310582200_CIT0001","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0140-6736(09)61204-6","article-title":"Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global 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