Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A.

Posfay Barbe, Klara; Galetto-Lacour, Annick; Grillet, Stéphane; Ochs, M M; Brookes, R H; Kraehenbuhl, J D; Cevey-Macherel, M; Gehri, M; Gervaix, Alain; Siegrist, Claire-Anne

doi:10.1111/j.1469-0691.2010.03389.x

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Title		Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A.
Authors		Posfay Barbe, Klara Galetto-Lacour, Annick Grillet, Stéphane Ochs, M M Brookes, R H Kraehenbuhl, J D Cevey-Macherel, M Gehri, M Gervaix, Alain Siegrist, Claire-Anne show all authors [1 - 10]
Published in		Clinical Microbiology and Infection. 2011, vol. 17, no. 8, p. 1232-8
Abstract		The aetiological diagnosis of community-acquired pneumonia (CAP) is challenging in children, and serological markers would be useful surrogates for epidemiological studies of pneumococcal CAP. We compared the use of anti-pneumolysin (Ply) antibody alone or with four additional pneumococcal surface proteins (PSPs) (pneumococcal histidine triad D (PhtD), pneumococcal histidine triad E (PhtE), LytB, and pneumococcal choline-binding protein A (PcpA)) as serological probes in children hospitalized with CAP. Recent pneumococcal exposure (positive blood culture for Streptococcus pneumoniae, Ply(+) blood PCR finding, and PSP seroresponse) was predefined as supporting the diagnosis of presumed pneumococcal CAP (P-CAP). Twenty-three of 75 (31%) children with CAP (mean age 33.7 months) had a Ply(+) PCR finding and/or a ≥ 2-fold increase of antibodies. Adding seroresponses to four PSPs identified 12 additional patients (35/75, 45%), increasing the sensitivity of the diagnosis of P-CAP from 0.44 (Ply alone) to 0.94. Convalescent anti-Ply and anti-PhtD antibody titres were significantly higher in P-CAP than in non P-CAP patients (446 vs. 169 ELISA Units (EU)/mL, p 0.031, and 189 vs. 66 EU/mL, p 0.044), confirming recent exposure. Acute anti-PcpA titres were three-fold lower (71 vs. 286 EU/mL, p <0.001) in P-CAP children. Regression analyses confirmed a low level of acute PcpA antibodies as the only independent predictor (p 0.002) of P-CAP. Novel PSPs facilitate the demonstration of recent pneumococcal exposure in CAP children. Low anti-PcpA antibody titres at admission distinguished children with P-CAP from those with CAP with a non-pneumococcal origin.
Keywords		Adhesins, Bacterial/immunology — Antibodies, Bacterial/blood — Bacterial Proteins/genetics/immunology — Carrier Proteins/immunology — Child, Preschool — Community-Acquired Infections/diagnosis/immunology — Humans — Lipoproteins/immunology — Membrane Proteins/immunology — Pneumonia, Pneumococcal/diagnosis/immunology — Sensitivity and Specificity — Streptococcus pneumoniae/immunology — Streptolysins/genetics/immunology
Identifiers		DOI: 10.1111/j.1469-0691.2010.03389.x PMID: 21040158
Full text		Article (Published version) (136 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique
Research groups		Centre de Vaccinologie et d'Immunologie néonatale (177) Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183) Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
Citation (ISO format)		POSFAY BARBE, Klara et al. Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A. In: Clinical Microbiology and Infection, 2011, vol. 17, n° 8, p. 1232-8. doi: 10.1111/j.1469-0691.2010.03389.x https://archive-ouverte.unige.ch/unige:25174