Clin. Lab. 11+12/2013 1 Clin. Lab. 2013;59:XXX-XXX ©Copyright CASE STUDY Evaluation of Pneumococcal PCR and Urinary Antigen Detection in Children ASLINUR ÖZKAYA PARLAKAY 1 , MEHMET CEYHAN 1 , MELDA ÇELIK 1 , YASEMIN ÖZSÜREKCI 1 , EDA KARADAĞ ÖNCEL 1 , GULNAR SENSOY 2 , NURSEN BELET 2 , MELIKE KESER EMIROGLU 3 , AHMET EMRE AYCAN 1 , KUMSAL ÇAĞLAR 1 1 Hacettepe University Pediatric Infectious Diseases Department, Ankara, Turkey 2 On Dokuz Mayıs University Pediatric Infectious Diseases Department, Samsun, Turkey 3 Necmettin Erbakan University Pediatric Infectious Diseases Department, Konya, Turkey SUMMARY Background: The rapid detection of Streptococcus pneumoniae could assist in the management of pneumococcal infections. The Binax NOW S. pneumoniae test is a rapid immunochromatographic test for this purpose. Methods: Multiplex PCR in parapneumonic pleural effusion fluid (PPEF) and cerebrospinal fluid (CSF) with Bi- nax NOW urinary pneumococcal antigen test (PAT) from 80 children was compared in this study. Results: PAT had a sensitivity of 36.4%, specificity of 97.3%, in CSF. PAT had a sensitivity of 50%, specificity of 81% for parapneumonic pleural effusion fluid. Conclusıons: When rapid management of a serious infection is needed the Binax NOW test could be a reliable method for the exclusion of S. pneumoniae infection. (Clin. Lab. 2013;59:xx-xx. DOI: 10.7754/Clin.Lab.2012.121206) KEY WORDS pneumococcal antigen test, S. Pneumoniae, child INTRODUCTION Streptococcus pneumoniae is a significant bacterial pathogen worldwide, causing meningitis, bacteremia, pneumonia, and acute otitis media and several other se- vere infections. To assist the diagnosis of pneumococcal diseases without delay, simple point-of-care tests for office practice are needed.The Binax NOW S. pneumo- niae test is a rapid immunochromatographic test origi- nally developed for the detection of S. pneumoniae anti- gens in urine samples and further validated for cerebro- spinal fluid (CSF) [1]. It has also been applied to vari- ous other specimens, including pharyngeal lavage fluid [2], middle ear fluid [3,4], bronchoalveolar lavage fluid [5] and pericardial fluid [6]. The test result is not affect- ed by antimicrobial treatment as easily as bacterial cul- ture because the test detects the C-polysaccharide of S. pneumoniae, which is shared by all pneumococcal serotypes, and does not need living bacteria [7,8]. The aim of our study is to study the reliability of the pneumococcal antigen test (PAT), using empyema and central nervous system samples, for infections caused by S. pneumoniae in children. MATERIALS AND METHODS We carried out a prospective study in the pediatric in- fectious diseases unit of a tertiary university hospital. Specimens were collected from children admitted to Hacettepe University, Ondokuz Mayis University and Necmettin Erbakan University Pediatric Infectious Dis- ease clinics. Specimens were either parapneumonic ef- fusion requiring diagnostic and/or therapeutic thoracen- tesis or CSF. The urine samples were tested prospec- tively for pneumococcal antigen with Binax NOW S. pneumoniae kit, whereas the EDTA-blood samples _____________________________________________ Case Study accepted February 20, 2013