Evaluation of the reliability of "NOW test" for detection of streptococcus pneumoniae infection in children with otitis media with effusion
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The present study was designed to evaluate the applicability of th.: use of the rapid test, NOW test, to middle ear effusions and to study its validity characters as a diagnostic test for streptococcus pneumoniae infection of the middle ear with effusion. The study included 40 children with chronic otitis media with effusion (OME) and scheduled for myringotomy. There were 10 patients with bilateral and 30 with unilateral OME. The middle ear effusions were collected at the time of myringotomy and were cultured and also processed for the NOW test. Twenty-nine (58%) specimens gave sterile culture, while the other twenty-one (42%) specimens gave bacterial growth. Streptococcus pneumoniae grew on 7 cultures. NOW test gave 9 positive results, 6 gave bacterial growth on culturing of the specimen while the other three specimens gave sterile culture. NOW test could diagnose the presence of streptococcus pneumoniae infection with sensitivity 85.7%, specificity 93%, and accuracy 92% and with a negative predictive value (1010 of 97.6%. NOW test could detect antibodies in three specimens of those diagnosed by culture as being sterile. Thus, NOW test could detect antibodies against streptococcus pneumoniae wall antigen with a sensitivity of 90%, specificity of .100%, and accuracy of the diagnosis being 98% and PPV of 100% and NPV of 97.6%. We can conclude that NOW test proved to be simple, rapid and reliable test for diagnosis of streptococcus pneumoniae infection and also could detect carriers of infection with a negative predictive value of 97.6%.