{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:03:08Z","timestamp":1790679788560,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,2,3]]},"abstract":"<jats:p>Prior antibiotic use, contamination, limited blood volume, and processing delays reduce yield of blood cultures for detection of <jats:italic>Streptococcus pneumoniae<\/jats:italic>. We performed immunochromatographic testing (ICT) on broth from incubated blood culture bottles and real-time <jats:italic>lytA<\/jats:italic> polymerase chain reaction (PCR) on broth and whole blood and compared findings to blood culture in patients with suspected bacteremia. We selected 383 patients in Mali and 586 patients in Thailand based on their blood culture results: 75 and 31 were positive for pneumococcus, 100 and 162 were positive for other pathogens, and 208 and 403 were blood culture negative, respectively. ICT and PCR of blood culture broth were at least 87% sensitive and 97% specific compared with blood culture; whole blood PCR was 75\u201388% sensitive and 96\u2013100% specific. Pneumococcal yields in children &lt; 5 years of age increased from 2.9% to 10.7% in Mali with &gt; 99% of additional cases detected by whole blood PCR, and from 0.07% to 5.1% in Thailand with two-thirds of additional cases identified by ICT. Compared with blood culture, ICT and <jats:italic>lytA<\/jats:italic> PCR on cultured broth were highly sensitive and specific but their ability to improve pneumococcal identification varied by site. Further studies of these tools are needed before widespread implementation.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0431","type":"journal-article","created":{"date-parts":[[2015,12,8]],"date-time":"2015-12-08T14:24:29Z","timestamp":1449584669000},"page":"267-275","source":"Crossref","is-referenced-by-count":6,"title":["Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study"],"prefix":"10.4269","volume":"94","author":[{"given":"Jennifer C.","family":"Mo\u00efsi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria da Gloria","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba O.","family":"Sow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duangkamon","family":"Siludjai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Deloria","family":"Knoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milagritos","family":"Tapia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry C.","family":"Baggett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Bull World Health Organ","first-page":"408","article-title":"Epidemiology and etiology of childhood pneumonia","volume":"86","author":"Rudan","year":"2008"},{"key":"ref2","series-title":"Lancet","first-page":"1969","article-title":"Global, regional, and national causes of child mortality in 2008: a systematic analysis","volume":"375","author":"Black","year":"2010"},{"key":"ref3","series-title":"Pediatr Infect Dis J","first-page":"779","article-title":"Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than 5 years of age for prevention of pneumonia: updated analysis using World Health Organization standardized interpretation of chest radiographs","volume":"25","author":"Hansen","year":"2006"},{"key":"ref4","series-title":"N Engl J Med","first-page":"1341","article-title":"A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection","volume":"349","author":"Klugman","year":"2003"},{"key":"ref5","series-title":"Lancet","first-page":"1139","article-title":"Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial","volume":"365","author":"Cutts","year":"2005"},{"key":"ref6","series-title":"Clin Infect Dis","first-page":"566","article-title":"Etiology of pneumonia and other common childhood infections requiring hospitalization and parenteral antimicrobial therapy. SE-TU Study Group","volume":"27","author":"Vuori","year":"1998"},{"key":"ref7","series-title":"Pediatr Infect Dis J","first-page":"42","article-title":"Etiology of acute lower respiratory tract infections in Gambian children: II. Acute lower respiratory tract infection in children ages one to nine years presenting at the hospital","volume":"10","author":"Forgie","year":"1991"},{"key":"ref8","series-title":"Pediatr Infect Dis J","first-page":"33","article-title":"Etiology of acute lower respiratory tract infections in Gambian children: I. Acute lower respiratory tract infections in infants presenting at the hospital","volume":"10","author":"Forgie","year":"1991"},{"key":"ref9","series-title":"J Pediatr","first-page":"190","article-title":"Effect of number of blood cultures and volume of blood on detection of bacteremia in children","volume":"128","author":"Isaacman","year":"1996"},{"key":"ref10","series-title":"BMC Infect Dis","first-page":"137","article-title":"Blood culture collection technique and pneumococcal surveillance in Malawi during the four year period 2003\u20132006: an observational study","volume":"8","author":"Mtunthama","year":"2008"},{"key":"ref11","series-title":"Am J Trop Med Hyg","first-page":"301","article-title":"Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence","volume":"83","author":"Rhodes","year":"2010"},{"key":"ref12","series-title":"Clin Infect Dis","first-page":"1511","article-title":"The impact of a 9-valent pneumococcal conjugate vaccine on the public health burden of pneumonia in HIV-infected and -uninfected children","volume":"40","author":"Madhi","year":"2005"},{"key":"ref13","series-title":"Binax NOW Streptococcus pneumoniae Package Insert","year":"2005"},{"key":"ref14","series-title":"Pediatr Infect Dis J","first-page":"791","article-title":"Urinary excretion of pneumococcal cell wall polysaccharide in children","volume":"21","author":"Faden","year":"2002"},{"key":"ref15","series-title":"Pediatr Infect Dis J","first-page":"718","article-title":"Evaluation of Binax NOW Streptococcus pneumoniae urinary antigen test in children in a community with a high carriage rate of pneumococcus","volume":"20","author":"Adegbola","year":"2001"},{"key":"ref16","series-title":"Clin Infect Dis","first-page":"824","article-title":"Evaluation of Binax NOW, an assay for the detection of pneumococcal antigen in urine samples, performed among pediatric patients","volume":"32","author":"Dowell","year":"2001"},{"key":"ref17","series-title":"Clin Infect Dis","first-page":"1025","article-title":"Assessment of the Binax NOW Streptococcus pneumoniae urinary antigen test in children with nasopharyngeal pneumococcal carriage","volume":"34","author":"Hamer","year":"2002"},{"key":"ref18","series-title":"Pediatr Infect Dis J","first-page":"365","article-title":"Evaluation of rapid assay for detection of Streptococcus pneumoniae urinary antigen among infants and young children with possible invasive pneumococcal disease","volume":"23","author":"Esposito","year":"2004"},{"key":"ref19","series-title":"J Clin Microbiol","first-page":"2161","article-title":"Usefulness of urinary antigen detection by an immunochromatographic test for diagnosis of pneumococcal pneumonia in children","volume":"41","author":"Dominguez","year":"2003"},{"key":"ref20","series-title":"Diagn Microbiol Infect Dis","first-page":"237","article-title":"Use of the NOW Streptococcus pneumoniae urinary antigen test in cerebrospinal fluid for rapid diagnosis of pneumococcal meningitis","volume":"45","author":"Samra","year":"2003"},{"key":"ref21","series-title":"Pediatr Infect Dis J","first-page":"148","article-title":"A randomized, multicenter, open-label clinical trial to assess the immunogenicity of a meningococcal C vaccine booster dose administered to children aged 14 to 18 months","volume":"29","author":"Diez-Domingo","year":"2010"},{"key":"ref22","series-title":"Pediatr Infect Dis J","first-page":"1093","article-title":"Rapid diagnosis of pneumococcal meningitis: implications for treatment and measuring disease burden","volume":"24","author":"Saha","year":"2005"},{"issue":"Suppl 2","key":"ref23","series-title":"Clin Infect Dis","first-page":"S49","article-title":"Enhanced diagnosis of pneumococcal meningitis with use of the Binax NOW immunochromatographic test of Streptococcus pneumoniae antigen: a multisite study","volume":"48","author":"Moisi","year":"2009"},{"key":"ref24","series-title":"J Clin Microbiol","first-page":"2510","article-title":"Streptococcus pneumoniae antigen test using positive blood culture bottles as an alternative method to diagnose pneumococcal bacteremia","volume":"43","author":"Petti","year":"2005"},{"key":"ref25","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"753","article-title":"Pneumococcal antigen testing of blood culture broth to enhance the detection of Streptococcus pneumoniae bacteremia","volume":"31","author":"Baggett","year":"2012"},{"key":"ref26","series-title":"J Trop Pediatr","first-page":"192","article-title":"Improving the sensitivity of blood culture for Streptococcus pneumoniae","volume":"57","author":"Saha","year":"2011"},{"key":"ref27","series-title":"J Clin Microbiol","first-page":"596","article-title":"Detection of Streptococcus pneumoniae in whole blood by PCR","volume":"33","author":"Zhang","year":"1995"},{"key":"ref28","series-title":"J Clin Microbiol","first-page":"2460","article-title":"Evaluation and improvement of real-time PCR assays targeting lytA, ply, and psaA genes for detection of pneumococcal DNA","volume":"45","author":"Carvalho","year":"2007"},{"key":"ref29","series-title":"Diagn Microbiol Infect Dis","first-page":"72","article-title":"Feasibility of real-time polymerase chain reaction in whole blood to identify Streptococcus pneumoniae in patients with community-acquired pneumonia","volume":"61","author":"Kee","year":"2008"},{"key":"ref30","series-title":"Chest","first-page":"832","article-title":"Severity of pneumococcal pneumonia associated with genomic bacterial load","volume":"136","author":"Rello","year":"2009"},{"key":"ref31","series-title":"J Clin Microbiol","first-page":"3308","article-title":"Streptococcus pneumoniae DNA load in blood as marker of infection in patients with community-acquired pneumonia","volume":"47","author":"Peters","year":"2009"},{"key":"ref32","series-title":"J Clin Microbiol","first-page":"124","article-title":"Sequential multiplex PCR approach for determining capsular serotypes of Streptococcus pneumoniae isolates","volume":"44","author":"Pai","year":"2006"},{"key":"ref33","series-title":"J Med Microbiol","first-page":"1181","article-title":"Sequential multiplex PCR for identifying pneumococcal capsular serotypes from south-Saharan African clinical isolates","volume":"56","author":"Morais","year":"2007"},{"key":"ref34","series-title":"J Med Microbiol","first-page":"1205","article-title":"Molecular detection methods and serotyping performed directly on clinical samples improve diagnostic sensitivity and reveal increased incidence of invasive disease by Streptococcus pneumoniae in Italian children","volume":"57","author":"Azzari","year":"2008"},{"key":"ref35","series-title":"Clin Infect Dis","first-page":"1042","article-title":"Community-acquired bacteremic pneumococcal pneumonia in children: diagnosis and serotyping by real-time polymerase chain reaction using blood samples","volume":"51","author":"Resti","year":"2010"},{"key":"ref36","series-title":"J Med Microbiol","first-page":"710","article-title":"Pneumococcal DNA is not detectable in the blood of healthy carrier children by real-time PCR targeting the lytA gene","volume":"60","author":"Azzari","year":"2011"},{"key":"ref37","series-title":"Diagn Microbiol Infect Dis","first-page":"452","article-title":"Use of 2 pneumococcal common protein real-time polymerase chain reaction assays in healthy children colonized with Streptococcus pneumoniae","volume":"70","author":"Rouphael","year":"2011"},{"key":"ref38","series-title":"J Clin Microbiol","first-page":"647","article-title":"Sequential triplex real-time PCR assay for detecting 21 pneumococcal capsular serotypes that account for a high global disease burden","volume":"51","author":"Pimenta","year":"2013"},{"key":"ref39","series-title":"J Clin Microbiol","first-page":"1611","article-title":"Revisiting pneumococcal carriage by use of broth enrichment and PCR techniques for enhanced detection of carriage and serotypes","volume":"48","author":"da Gloria Carvalho","year":"2010"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/94\/2\/article-p267.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/94\/2\/article-p267.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/94\/2\/article-p267.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:14:55Z","timestamp":1723068895000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/94\/2\/article-p267.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,3]]},"references-count":39,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.15-0431","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,3]]}}}