Usefulness of Immunohistochemical Diagnosis of Streptococcus pneumoniae in Formalin-Fixed, Paraffin-Embedded Specimens Compared With Culture and Gram Stain Techniques

Jeannette Guarner; Michelle Packard; Kurt Nolte; Christopher Paddock; Wun-Ju Shieh; Maria Tondella; Lesley McGee; Sherif Zaki
April 2007
American Journal of Clinical Pathology;Apr2007, Vol. 127 Issue 4, p612
Academic Journal
Streptococcus pneumoniae is the most frequent cause of pneumonia and meningitis. Because S pneumoniae can colonize the upper respiratory tract and antibiotic treatment may inhibit growth, culture-based diagnosis can be problematic. An immunohistochemical assay using a polyclonal antibody against pneumococci was used to test formalin-fixed, paraffin-embedded tissue samples from 46 patients for whom bacterial culture results were available. Samples from 26 patients demonstrated pneumococcal antigens in areas of pneumonia, meningitis, or osteomyelitis or within circulating inflammatory cells. Various specimens from 18 patients grew S pneumoniae, whereas 8 had cultures that grew mixed bacteria or had no growth but were polymerase chain reaction-positive for the S pneumoniae Ity A gene. Pneumococcal antigens were not present in 20 cases (7 grew Streptococcus pyogenes; 9, Staphylococcus aureus; and 4, Haemophilus influenzae). Compared with culture, the immunohistochemical assay showed 100% sensitivity and 71% specificity. Immunohistochemical analysis has the diagnostic advantage of correlating host inflammatory reaction with presence of pneumococci.


Related Articles

  • Pneumococcal Meningitis in the Adult. Olsson, Ray A.; Kirby, James C.; Romansky, Monroe J. // Annals of Internal Medicine;Oct61, Vol. 55 Issue 4, p545 

    Studies cases of pneumococcal meningitis in 43 adult patients seen during the years 1950 through 1960 in the George Washington University Medical Division in Washington, D.C. Unusual characteristics of pneumococcus; Clinical characteristics of pneumococcal meningitis; Factors that were...

  • A 20-Year Epidemiological Study of Pneumococcal Meningitis. Stanek, Ronald J.; Mufson, Maurice A. // Clinical Infectious Diseases;6/1/1999, Vol. 28 Issue 6, p1265 

    Conducts a retrospective analysis of community-acquired streptococcus pneumoniae meningitis illnesses in Huntington, West Virginia, from 1978 to 1997. Case fatality rate by age among persons with pneumococcal meningitis; Incidence of pneumococcal meningitis; Underlying diseases in the death of...

  • Toll-Like Receptor 2--Deficient Mice Are Highly Susceptible to Streptococcus pneumoniae Meningitis because of Reduced Bacterial Clearing and Enhanced Inflammation. Echchannaoui, Hakim; Frei, Karl; Schnell, Christian; Leib, Stephen L.; Zimmerli, Werner; Landmann, Regine // Journal of Infectious Diseases;9/15/2002, Vol. 186 Issue 6, p798 

    Toll-like receptor-2 (TLR2) mediates host responses to gram-positive bacterial wall components. TLR2 function was investigated in a murine Streptococcus pneumoniae meningitis model in wild-type (wt) and TLR2-deficient (TLR2[sup -/-]) mice. TLR2[sup -/-] mice showed earlier time of death than wt...

  • Evaluation of the Immunochromatographic Binax NOW Assay for Detection of Streptococcus pneumoniae Urinary Antigen in a Prospective Study of Community-Acquired Pneumonia in Spain. Gutiérrez, Félix; Masiá, Mar; Rodriguez, J. Carlos; Ayelo, Antonio; Soldán, Bernardo; Cebrián, Laura; Mirete, Carlos; Royo, Gloria; Hidalgo, Alberto M. // Clinical Infectious Diseases;2/1/2003, Vol. 36 Issue 3, p286 

    We evaluated the Binax NOW rapid immunochromatographic membrane test (ICT) for detection of Streptococcus pneumoniae urinary antigen in a population-based prospective study of adults with communityacquired pneumonia (CAP). ICT was performed with urine samples obtained from 452 (91.7%) of 493...

  • Constancy of Distribution of Serogroups of Invasive Pneumococcal Isolates Among Children: Experience during 4 Decades. Babl, Franz E.; Pelton, Steven I.; Theodore, Sam; Klein, Jerome O. // Clinical Infectious Diseases;4/15/2001, Vol. 32 Issue 8, p1155 

    Presents information on a study which examined the serogroups of pneumococci that caused bacteremia or meningitis in children from 1981 to 1998 in Boston, Massachusetts. Methodology; Results of the study; Discussion.

  • A Novel, Multiple Drug-Resistant, Serotype 24F Strain of Streptococcus pneumoniae That Caused Meningitis in Patients in Naples, Italy. Pantosti, Annalisa; Gherardi, Giovanni; Conte, Marco; Faella, Francesco; Dicuonzo, Giordano; Beall, Bernard // Clinical Infectious Diseases;7/15/2002, Vol. 35 Issue 2, p205 

    Presents case studies of adult patients who developed meningitis due to multiple drug-resistant serotype 24F Streptococcus pneumoniae isolates in Italy. Clinical presentation of the patients; Treatment administered to the patients; Characterization of the isolates.

  • Fatal Meningitis Due to Levofloxacin-Resistant Streptococcus pneumoniae . Wortmann, Glenn W.; Bennett, Steven P. // Clinical Infectious Diseases;12/1/1999, Vol. 29 Issue 6, p1599 

    Reports on a case of a patient with fatal Streptococcus pneumoniae bacteremia and meningitis that occurred despite treatment with levofloxin. Laboratory findings; Prevalence of fluroquinolone-resistant S. pneumoniae.

  • Anterior abdominal wall abscess caused by Streptococcus pneumoniae in a patient with self-inflicted stab injury: An unusual presentation. Kumar, Shailesh; Umadevi, Sivaraman; Easow, Joshy M.; Joseph, Noyal Mariya; Srirangaraj, Sreenivasan; Kumari, Kandha; Stephen, Selvaraj // Journal of Infection in Developing Countries;Apr2011, Vol. 5 Issue 4, p307 

    Streptococcus pneumoniae is a major cause of community-acquired pneumonia, otitis media, paranasal sinusitis, bacteremia and meningitis, as well as osteomyelitis and occasionally peritonitis. We report the case of a 25-year-old female who had stabbed herself with a kitchen knife above the...

  • Novel Approaches To Fight Streptococcus pneumoniae. Maestro, Beatriz; Sanz, Jesús M. // Recent Patents on Anti-Infective Drug Discovery;Nov2007, Vol. 2 Issue 3, p188 

    Streptococcus pneumoniae affects millions of people worldwide. It is responsible for a wide spectrum of serious illnesses such as pneumonia, meningitis and bacteraemia. The highest rate of pneumococcal disease (and the highest mortality) occurs in young children, as well as in the elderly and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics