COUNTERCURRENT IMMUNOELECTROPMORESIS (CIE) OF RESPIRATORY SECRETIONS IN THE DIAGNOSIS OF PNEUMONIA

Abstract

Several recent studies in adults have indicated that CIE as opposed to routine culture of sputum can distinguish patients with pneumococcal pneumonia vs. those simply colonized with the pneumococcus - CIE being positive in the former and negative in the latter. A prospective study was undertaken to evaluate this observation by performing CIE determinations on nasopharyngeal (NP) secretions in 14 children with bacterial pneumonia as evidenced by physical and radiologic findings as well as the presence of leukocytosis, response to a penicillin and in some cases evidence of bloodstream invasion. Thirty-five children with other types of respiratory illness served as controls. Nine of 13 from the pneumonia group had pneumococcal antigen in their NP secretions. Three of 4 negative patients had evidence of disease due to type-14 pneumococcus, not generally detected by CIE. The one additional pneumonia patient had a positive blood culture for Hemophilus influenzae type b (Hib) and Hib antigen was present in the NP secretions. In the control group, one patient had pneumococcal antigen and one patient had Hib antigen in the NP secretions, although 17/35 were positive for pneumococcus by culture. CIE on NP secretions is reliable in distinguishing patients with pneumococcal pneumonia vs. those who are simply carriers (p<.001).

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