耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
急性鼻副鼻腔炎に対する肺炎球菌迅速キットの有用性
宮部 はるか川島 佳代子
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ジャーナル 認証あり

2014 年 107 巻 8 号 p. 609-615

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Since Streptococcus pneumonia has severe pathogenicity and the incidence of penicillin-resistant S. pneumoniae has been increasing, it is important to identify S. pneumonia rapidly as the pathogenic bacterium to enable appropriate antimicrobial treatment. However, especially in the case of pediatric rhinosinusitis, S. pneumoniae is one of the normal inhabitants of the nasopharynxes, so it is difficult to identify it as a pathogenic bacterium. We investigated the usefulness of a pneumococcal antigen detection kit, RAPIRAN® S. pneumoniae HS (HS kit) for the detection of pathogenic bacteria associated with acute rhinosinusitis.
We have evaluated 134 nasopharyngeal secretions (72 children, 62 adults), and have examined the HS kit, culture test and microscopic examination (Gram stein), and made comparisons among them.
The positive rate of the HS kit was 38.9% in children, and 6.5% in adults, with a sensitivity of 65.2%, a specificity 97.7% and a concordance rate of 86.6%. Furthermore, in the culture test, the HS kit(+) dominant bacterium was S. pneumoniae, whereas the HS kit(-) dominant bacterium were Haemophilus influenzae and Moraxella catarrhalis.
Based on our results, we concluded that the HS kit could be useful for the detection of pathogenic bacteria associated with acute rhinosinusitis, so that if the HS kit is positive, the pathogenic bacterium is probably S. pneumoniae, and if the HS kit is negative, the pathogenic bacteria are probably others, with the exception of S. pneumoniae.
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