A rapid simultaneous antigen detection of Haemophilus influenzae and Streptococcus pneumoniae for predicting the prognosis of acute otitis media.

Haemophilus influenzae Streptococcus pneumoniae acute otitis media rapid immunochromatographic test

Journal

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
ISSN: 1437-7780
Titre abrégé: J Infect Chemother
Pays: Netherlands
ID NLM: 9608375

Informations de publication

Date de publication:
21 May 2024
Historique:
received: 17 11 2023
revised: 14 05 2024
accepted: 17 05 2024
medline: 24 5 2024
pubmed: 24 5 2024
entrez: 23 5 2024
Statut: aheadofprint

Résumé

Rapid identification of causative bacteria in treatment of acute otitis media (AOM) is of paramount importance for appropriate antibiotic use. This prospective observational study was conducted in 15 hospitals and clinics in Japan between 2018 and 2020. A new rapid antigen test kit (AOS-116), which simultaneously detects antigens for Streptococcus pneumoniae (Sp) and Haemophilus influenzae (Hi), was applied for middle ear fluids (MEFs) and nasopharyngeal swabs (NPSs) in patients with moderate to severe AOM. We investigated relationship between the results of rapid test, severity at initial visit, and clinical course. Regarding performance accuracy based on culture results, AOS-116 showed 1) high (>80%) sensitivity, specificity, and negative predictive value (NPV) in MEFs for both antigens, 2) high sensitivity, specificity, and positive predictive value (PPV) in NPSs for Hi antigen, and 3) high specificity, and PPV in NPSs for Sp antigen. Regarding predictive value of nasopharyngeal culture and antigen detection for causative middle ear pathogens, similar results were observed between AOS-116 and culture, which was characterized with high sensitivity and NPV for both pathogens. MEFs/NPSs positive for Hi antigen were significantly associated with eardrum findings, and severity. MEFs/NPSs positive for pneumococcal antigen were significantly associated with severity of otalgia, fever, and otorrhea. Among patients with prior antimicrobial treatment, improvement tended to be slower in cases positive for Hi than in cases negative. The rapid antigen detection test is useful as a decision-making tool for prescribing antimicrobial agents and may play an important role in promoting appropriate antimicrobial use.

Sections du résumé

BACKGROUND BACKGROUND
Rapid identification of causative bacteria in treatment of acute otitis media (AOM) is of paramount importance for appropriate antibiotic use.
MATERIALS AND METHODS METHODS
This prospective observational study was conducted in 15 hospitals and clinics in Japan between 2018 and 2020. A new rapid antigen test kit (AOS-116), which simultaneously detects antigens for Streptococcus pneumoniae (Sp) and Haemophilus influenzae (Hi), was applied for middle ear fluids (MEFs) and nasopharyngeal swabs (NPSs) in patients with moderate to severe AOM. We investigated relationship between the results of rapid test, severity at initial visit, and clinical course.
RESULTS RESULTS
Regarding performance accuracy based on culture results, AOS-116 showed 1) high (>80%) sensitivity, specificity, and negative predictive value (NPV) in MEFs for both antigens, 2) high sensitivity, specificity, and positive predictive value (PPV) in NPSs for Hi antigen, and 3) high specificity, and PPV in NPSs for Sp antigen. Regarding predictive value of nasopharyngeal culture and antigen detection for causative middle ear pathogens, similar results were observed between AOS-116 and culture, which was characterized with high sensitivity and NPV for both pathogens. MEFs/NPSs positive for Hi antigen were significantly associated with eardrum findings, and severity. MEFs/NPSs positive for pneumococcal antigen were significantly associated with severity of otalgia, fever, and otorrhea. Among patients with prior antimicrobial treatment, improvement tended to be slower in cases positive for Hi than in cases negative.
CONCLUSION CONCLUSIONS
The rapid antigen detection test is useful as a decision-making tool for prescribing antimicrobial agents and may play an important role in promoting appropriate antimicrobial use.

Identifiants

DOI: 10.1016/j.jiac.2024.05.006 PMID: 38782238
pubmed: 38782238
pii: S1341-321X(24)00138-7
doi: 10.1016/j.jiac.2024.05.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare financial support from ASAHI KASEI Corporation. Takuji Miyata and Norikazu Okamura are employees of Asahi Kasei Corporation. The funder had no role in the experimental design, implementation of the study, interpretation of the data, or decision to submit the manuscript for publication. This does not alter the authors’ adherence to any publication policies on sharing data and materials.

Auteurs

Masamitsu Kono (M)

Department of Otorhinolaryngology Head and Neck Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.

Yosuke Kamide (Y)

Kamide ENT Clinic, Fuji, Shizuoka, Japan.

Toshihiro Tanaka (T)

Department of Pediatrics, Shizuoka Welfare Hospital, Shizuoka, Shizuoka, Japan.

Yoshifumi Uno (Y)

Uno ENT Clinic, Okayama, Okayama, Japan.

Keiko Kanesada (K)

Nonohana ENT Clinic, Yamaguchi, Yamaguchi, Japan.

Chiaki Suzuki (C)

Paopao ENT Clinic, Date, Fukushima, Japan.

Seiji Sawaki (S)

Kikuna ENT Clinic, Yokohama, Kanagawa, Japan.

Masaru Kunimoto (M)

Kunimoto ENT Clinic, Hiroshima, Hiroshima, Japan.

Chikako Kayama (C)

Kayama Clinic, Sumoto, Hyogo, Japan.

Kenji Suzuki (K)

Yonaha Hospital, Kuwana, Mie, Japan.

Fumiyo Kudo (F)

Alice ENT Clinic, Chiba, Chiba, Japan.

Shigenori Matsubara (S)

Matsubara ORL Clinic, Seki, Gifu, Japan.

Shoichi Sawada (S)

Sawada Eye and Ear Clinic, Kochi, Kochi, Japan.

Yukako Goto (Y)

Department of Otorhinolaryngology, Konan Hospital, Kobe, Hyogo, Japan.

Akihiro Uchizono (A)

Sendai ENT Clinic, Satsumasendai, Kagoshima, Japan.

Daichi Murakami (D)

Department of Otorhinolaryngology Head and Neck Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan.

Takuji Miyata (T)

Asahi Kasei Corporation, Corporate Research & Development, Healthcare R&D Center, Rapid Diagnostic Technology, Fuji, Shizuoka, Japan.

Norikazu Okamura (N)

Asahi Kasei Corporation, Corporate Research & Development, Healthcare R&D Center, Clinical Development Department, Chiyoda-ku Yuraku-cho, Tokyo, Japan.

Muneki Hotomi (M)

Department of Otorhinolaryngology Head and Neck Surgery, Wakayama Medical University, Wakayama, Wakayama, Japan. Electronic address: mhotomi@wakayama-med.ac.jp.

Classifications MeSH