Nadal
Fakultäten » Medizinische Fakultät » Kinderspital Zürich: Medizinische Klinik » Infektiologie, Abteilung » Prof. Dr. David Nadal » Nadal
Completed research project
| Title / Titel | The impact of conjugate heptavalent pneumococcal vaccine on improving diagnosis of invasive pneumococcal infections by detection of pneumococcal antigen in urine | ||||||||
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| Abstract (PDF, 14 KB) | |||||||||
| Summary / Zusammenfassung | Streptococcus pneumoniae is the most common cause of invasive bacterial infections including meningitis, bacteraemia and pneumonia in young children. Very recently, a conjugate heptavalent pneumococcal polysaccharide vaccine has been introduced in the official general vaccination recommendations in Switzerland. This vaccine reduces nasopharyngeal carriage of pneumococci and in turn invasive pneumococcal infections. Etiological diagnosis of invasive infections can be established by detection of pneumococci in normally sterile body fluids including blood. Given that bactaeremia occurs in only up to one third of the cases the etiological diagnosis of pneumococcal pneumonia cannot be established in the vast majority of cases. Various studies have evaluated the utility of a rapid urine immunochromatographic pneumococcal antigen assay in the pediatric population, and the results suggest that the urine assay demonstrates high sensitivity of 96% for proven (bacteraemic) invasive pneumococcal infection. Nevertheless, nasopharyngeal carriage of pneumococci increases the likelihood of pneumococcal antigen detection in urine and seems to account for the rate of false positive results of around 15%. Thus, reduction in nasopharyngeal carriage following vaccination could result in an improved specificity of pneumococcal antigen detection in urine to diagnose invasive pneumococcal disease. This, however, could be counteracted by bacterial replacement in the nasopharynx by non-vaccine pneumococcal strains. The goal of this study is to investigate the diagnostic accuracy of pneumococcal antigen detection in urine after introduction of conjugate heptavalent pneumococcal vaccine by correlating nasopharyngeal pneumococcal carriage with pneumococcal antigen excretion in urine in vaccinated versus non-vaccinated children with different underlying medical conditions. | ||||||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Private Sector (e.g. Industry) |
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| Duration of Project / Projektdauer | Mar 2007 to Feb 2010 |