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Accuracy of High-Throughput Nanofluidic PCR-Based Pneumococcal Serotyping and Quantification Assays Using Sputum Samples for Diagnosing Vaccine Serotype Pneumococcal Pneumonia: Analyses by Composite Diagnostic Standards and Bayesian Latent Class Models


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タイトル: Accuracy of High-Throughput Nanofluidic PCR-Based Pneumococcal Serotyping and Quantification Assays Using Sputum Samples for Diagnosing Vaccine Serotype Pneumococcal Pneumonia: Analyses by Composite Diagnostic Standards and Bayesian Latent Class Models
著者: Kakiuchi, Satoshi / Suzuki, Motoi / Dhoubhadel, Bhim Gopal / Furumoto, Akitsugu / Ito, Hiroyuki / Matsuki, Kei / Tsuchihashi, Yoshiko / Asoh, Norichika / Yasunami, Michio / Ariyoshi, Koya / Morimoto, Konosuke
発行日: 2018年 5月
出版者: American Society for Microbiology
引用: Journal of Clinical Microbiology, 56(5), e01874-17; 2018
抄録: The lack of reliable diagnostic tests for detecting vaccine serotype pneumococcal pneumonia (VTPP) remains a challenging issue in pneumococcal vaccine studies. This study assessed the performances of high-throughput nanofluidic PCR-based pneumococcal serotyping and quantification assay methods using sputum samples (the nanofluidic sputum quantitative PCR [Sp-qPCR] assay) to diagnose 13-valent pneumococcal conjugate VTPP compared with the performance of the serotype-specific urinary antigen detection (UAD) assay using urine samples. Adult pneumonia patients from Japan were enrolled in this study between September 2012 and August 2014. Sputum samples were subjected to the nanofluidic Sp-qPCR assay, quantitatively cultured, and serotyped by the Quellung reaction (SpQt). Urine samples were tested by the UAD method. The diagnostic performances of these tests were assessed using composite reference standards and Bayesian latent class models (BLCMs). Among 244 total patients, 27 (11.1%) tested positive with the UAD assay, while 16 (6.6%) and 34 (13.9%) tested positive with the SpQt and nanofluidic Sp-qPCR assays, respectively, with a cutoff value of 104 DNA copies/ml, which showed the maximum value of the Youden index. Using BLCMs, the estimated prevalence for VTPP was 12.9%, and the nanofluidic Sp-qPCR assay demonstrated the best performance (sensitivity, 90.2%; specificity, 96.9%), followed by UAD (sensitivity, 75.6%; specificity, 97.9%) and SpQt (sensitivity, 45.8%; specificity, 99.5%). However, when a higher cutoff value of 107 DNA copies/ml was applied, the performance of UAD became comparable to that of Sp-qPCR. The vaccine serotype-specific pneumococcal DNA load in sputum among UAD-positive patients was 3 logs higher than that among UAD-negative patients (P 0.036). The nanofluidic Sp-qPCR assay may be accurate and useful for detecting VTPP among adults.
キーワード: Bayesian latent class models / Streptococcus pneumoniae / adult pneumonia / sputum culture / sputum real-time PCR / urinary antigen detection
URI: http://hdl.handle.net/10069/38217
ISSN: 00951137
DOI: 10.1128/JCM.01874-17
権利: © 2018 Kakiuchi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.
資料タイプ: Journal Article
原稿種類: publisher
出現コレクション:120 学術雑誌論文

引用URI : http://hdl.handle.net/10069/38217

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