Open AccessThe role of latex agglutination test for the etiological diagnosis of pleural effusion in children and adolescents
Author(s) -
Camargos Paulo,
Fonseca Ana Cristina,
Amantéa Sérgio,
Oliveira Elizabeth,
Benfica Maria das Graças,
Chamone Chequer
Publication year - 2017
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12348
Subject(s) - medicine , confidence interval , etiology , streptococcus pneumoniae , pleural effusion , latex fixation test , haemophilus influenzae , population , direct agglutination test , likelihood ratios in diagnostic testing , gastroenterology , surgery , antibiotics , immunology , serology , microbiology and biotechnology , antibody , environmental health , biology
The etiological diagnosis of pleural effusion is a difficult task because the diagnostic tools can only establish a definitive etiological diagnosis in at most 76% of cases. Objectives To verify the diagnostic accuracy of the latex agglutination test (LAT) for the etiological diagnosis of pleural effusions caused by Streptococcus pneumoniae and Haemophilus influenzae type b . Methods After thoracocentesis, paired fresh samples of pleural fluid from 418 children and adolescents were included in this investigation. They were tested blindly and simultaneously through counterimmunoelectrophoresis (CIE) and LAT for both bacteria. Sensitivity, specificity, predictive values and likelihood ratios (LR) were calculated taking CIE as a reference standard. Results The sensitivity and specificity of LAT was 100% (95% confidence interval, 94.4%–100%) and 83.3% (95% confidence interval, 79.0%–87.0%), respectively, whereas the positive (calculated from Bayes’ theorem) and negative predictive values were, respectively, lower than 1% and 100% (95% confidence interval, 98.8%–100%). Positive and negative LR were 6.0 (95% confidence interval, 4.7–7.6) and zero, respectively. Conclusions Our results suggest that LAT is a useful tool for the etiological diagnosis of pleural effusion. It is a reliable, rapid, simple to perform and shows an excellent yield in our studied population, helping to prescribe appropriate antibiotics for this clinical condition.