TY - JOUR T1 - Evaluation of a rapid antigen test for detection of <em>Streptococcus pneumoniae</em> in cerebrospinal fluid JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 448 LP - 450 DO - 10.1136/jclinpath-2016-204104 VL - 70 IS - 5 AU - Angel Boulos AU - Derek Fairley AU - James McKenna AU - Peter Coyle Y1 - 2017/05/01 UR - http://jcp.bmj.com/content/70/5/448.abstract N2 - Detection of Streptococcus pneumoniae antigen in cerebrospinal fluid (CSF) using lateral flow immunochromatography tests (ICTs) is an effective, rapid and low-cost method to diagnose pneumococcal meningitis. This study evaluated the diagnostic accuracy of the Uni-Gold ICT to detect pneumococcal antigen in CSF specimens, compared with gold standard bacteriology and quantitative real-time PCR (qPCR) testing. CSF specimens (n=69) from patients with suspected bacterial meningitis were included in the study. 13/69 (19%) were positive and 56/69 (81%) were negative for pneumococcus by the gold standard tests. The ICT had sensitivity of 85% (55%–98%), specificity of 96% (88%–100%), positive likelihood ratio of 23.7 (6–94) and negative likelihood ratio of 0.16 (0.04–0.57). Overall, a strong correlation between the ICT and qPCR results was seen (κ=0.81). In contrast, CSF microscopy and culture were exceptionally insensitive. The ICT method is sufficiently robust and accurate for use in algorithms to diagnose bacterial meningitis. ER -