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The Binax NOW test as a tool for diagnosis of severe acute otitis media and associated complications

Marie Gisselsson-Solén1, Anita Bylander, Christina Wilhelmsson

  • 1Department of Oto-Rhino-Laryngology, Lund University Hospital, Lund, Sweden.

Journal of Clinical Microbiology
|July 20, 2007
PubMed

Insights

The Binax NOW rapid antigen assay effectively detects Streptococcus pneumoniae in severe acute otitis media (AOM), aiding diagnosis even with complications. This diagnostic tool shows high accuracy in middle ear fluid specimens.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Diagnostic Microbiology

Background:

  • Accurate diagnosis of acute otitis media (AOM) is challenging, relying on clinical expertise.
  • Identifying AOM with potential complications is crucial for timely and appropriate treatment.
  • Streptococcus pneumoniae is a common pathogen in severe AOM.

Purpose of the Study:

  • To evaluate the Binax NOW rapid antigen assay for diagnosing Streptococcus pneumoniae in severe AOM.
  • To assess the test's utility in AOM cases with and without complications.
  • To compare the diagnostic performance of the Binax NOW test with culture and PCR methods.

Main Methods:

  • The study included 70 patients with 74 episodes of AOM, including 18 with complications.
  • Nasopharyngeal secretions and middle ear fluid were analyzed using cultures, Binax NOW tests, and PCR.
  • Additional samples included mastoid bone, cerebrospinal fluid, and urine in select cases.

Main Results:

  • Streptococcus pneumoniae caused 41% of AOM episodes based on culture and PCR of middle ear fluid.
  • The Binax NOW test correctly identified S. pneumoniae in 80% of culture/PCR-confirmed cases.
  • For middle ear specimens, the Binax NOW test demonstrated 85% sensitivity, 100% specificity, and 89% negative predictive value.

Conclusions:

  • The Binax NOW test is a valuable tool for diagnosing S. pneumoniae in severe AOM, regardless of complications.
  • The assay shows high diagnostic accuracy when using middle ear fluid specimens.
  • The test's performance is less reliable with nasopharyngeal secretions compared to middle ear fluid.

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