STREPTOCOCCUS PNEUMONIAE IgG AB, 14 serotypes

Code
900.3550
Name
STREPTOCOCCUS PNEUMONIAE IgG AB, 14 serotypes
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
CPT Codes
86317 X14
Site
SBMF
Reference Test
44342
ATLAS Test Code

Specimen Information

Type

Gold, SST

Volume

1.5 ml

Transport Info

Centrifuge and immediately transfer serum to separate plastic tube
Refrigerated

Fasting Required?
False
Patient Instructions

Test includes: Serotypes 1, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 12F, 14, 18C, 19F, 23F

Reference Range

See Report

Methodology

Quantitative Multi-Analyte Fluorescence Detection (MAFD)

Clinical Significance

The intended use for the test is to quantitate antibody levels to pneumococcal polysaccharides in persons receiving pneumococcal vaccine. Antibody levels indicate whether the vaccine recipient has responded to the vaccine and if protective levels of antibodies have been reached.

Streptococcus pneumoniae is a leading cause of invasive and noninvasive bacterial infections in persons of all ages. Pneumococcal disease kills more people in the United States (40,000) than any other vaccine-preventable disease. S. pneumoniae typically are gram-positive, lancet-shaped diplococci, but in clinical samples may appear in chains or as single cocci. S. pneumoniae that are pathogenic in humans are heavily encapsulated. The virulence of the pneumococcal organism is determined by the composition of the capsular polysaccharide. Differences in the chemical structure of capsular polysaccharides also provide the basis for serotype classification. Some 90 different serotypes have been identified but only 7 serotypes cause 80% of pneumococcal disease in children in the United States. Humans are the natural reservoir for S. pneumoniae. The organism colonizes the nasopharynx and is spread by direct person-to-person contact via droplets. Most cases of pneumococcal infection occur via autoinoculation in persons who are asymptomatic when the organism migrates from the nasopharynx to normally sterile sites. One or more types can be isolated from the nasopharynx in 5% to 70% of the normal healthy population. Carriage rates vary but are higher in closed communities such as day care centers, orphanages, and military installations. Carriage rates are significantly higher in children than adults and may approach 60% in preschool children and 35% in elementary school children. In carriers of S. pneumoniae, the organism may evade host defense mechanisms and cause invasive disease. The highest rates of invasive pneumococcal disease occur in young children, especially those less than 2 years of age. These children have low concentrations of IgG2 subclass (which usually contains most of the antibodies against pure polysaccharide antigens) and fail to respond adequately to pure polysaccharide vaccines. S. pneumoniae is responsible for 50% of all cases of pneumonia. Pneumococcal pneumonia often develops during the course of viral infections of the upper respiratory tract, particularly influenza and measles. Pneumococcal pneumonia is effectively treated with penicillin or other antibiotics unless the treatment is delayed, the bacteria are resistant, or the patient is compromised by another debilitating illness. Bacteremia occurs in about 25-30% of patients with pneumococcal pneumonia. S. pneumoniae causes 85% of all cases of bacteremia in the pediatric population. The overall mortality rate for bacteremia is about 20%, but may reach 60% in elderly patients. With the success of conjugate vaccines in preventing invasive Haemophilus influenzae type b disease, S. pneumoniae has become the leading cause of bacterial meningitis in the United States. S. pneumoniae is responsible for an estimated 6,000 cases of bacterial meningitis in the United States each year. The mortality rate for pneumococcal meningitis is about 30% but approaches 80% in elderly patients. Among children, the mortality rate for pneumococcal meningitis is about 6%. Children who survive, however, often experience significant neurological side effects and/ or hearing loss. S. pneumoniae is also a frequent cause of upper respiratory tract infections accounting for 30% to 50% of the cases of otitis media and 40% of the cases of sinusitis. Approximately 80% of children in the United States have at least one episode of otitis media by age three and 50% have greater than 3 episodes. Over 500,000 children undergo insertion of tympanostomy tubes for recurrent otitis media. Acute otitis media is the most common reason for pediatric office visits in the United States and the most common reason for antibiotic prescriptions. Over prescription of antibiotics has lead to a dramatic increase in the number of S. pneumoniae isolates that are not susceptible to antibiotics. Consequently, children are the primary reservoir for drug- resistant pneumococci. Up to 35% of pneumococcal isolates are not susceptible to penicillin and approximately half of these are also resistant to cephalosporins. The intended use for the test is to quantitate antibody levels to pneumococcal polysaccharides in persons receiving pneumococcal vaccine. Antibody levels indicate whether the vaccine recipient has responded to the vaccine and if protective levels of antibodies have been reached. Pre- and one-month post- immunization samples should be run simultaneously and should, therefore, be clearly dated and marked as pre-vaccine or post-vaccine.

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