BACKGROUND AND OBJECTIVE: Urinary pneumococcal antigen detection provides good results in the diagnosis of pneumococcal pneumonia but has rarely been used in bacteraemic pneumococcal pneumonia and it is not known whether it is associated with outcome in this type of pneumonia. Our objectives were to assess the usefulness of an immunochromatographic technique for detecting the pneumococcal antigen in urine in a large prospective study of patients with bacteraemic pneumococcal pneumonia and explore any potential association with outcomes. METHODS: This study, carried out over 8 years, included all adult immunocompetent patients admitted for bacteraemic pneumococcal pneumonia. An immunochromatographic test for the Streptococcus pneumoniae antigen in urine was performed in the first 24 h. The sensitivity of test was assessed and patients were divided into two groups according to test results to explore differences on admission and during the course of the illness using logistic regression models. RESULTS: Of the 350 patients with bacteraemic pneumococcal pneumonia included, 261 (74.6%) were positive for the antigen. Patient characteristics were very similar on admission and differences in severity (Pneumonia Severity Index) were not statistically significant. In the adjusted analysis, antigen-positive patients had a higher risk of intensive care unit admission, treatment failure and adverse outcome. CONCLUSIONS: The sensitivity of the immunochromatographic urinary antigen test was 74.6% and positive results were associated with poorer clinical outcome. We therefore recommend systematic use of this test when pneumonia is diagnosed in the emergency department.
BACKGROUND AND OBJECTIVE: Urinary pneumococcal antigen detection provides good results in the diagnosis of pneumococcal pneumonia but has rarely been used in bacteraemic pneumococcal pneumonia and it is not known whether it is associated with outcome in this type of pneumonia. Our objectives were to assess the usefulness of an immunochromatographic technique for detecting the pneumococcal antigen in urine in a large prospective study of patients with bacteraemic pneumococcal pneumonia and explore any potential association with outcomes. METHODS: This study, carried out over 8 years, included all adult immunocompetent patients admitted for bacteraemic pneumococcal pneumonia. An immunochromatographic test for the Streptococcus pneumoniae antigen in urine was performed in the first 24 h. The sensitivity of test was assessed and patients were divided into two groups according to test results to explore differences on admission and during the course of the illness using logistic regression models. RESULTS: Of the 350 patients with bacteraemic pneumococcal pneumonia included, 261 (74.6%) were positive for the antigen. Patient characteristics were very similar on admission and differences in severity (Pneumonia Severity Index) were not statistically significant. In the adjusted analysis, antigen-positive patients had a higher risk of intensive care unit admission, treatment failure and adverse outcome. CONCLUSIONS: The sensitivity of the immunochromatographic urinary antigen test was 74.6% and positive results were associated with poorer clinical outcome. We therefore recommend systematic use of this test when pneumonia is diagnosed in the emergency department.
Authors: V Blanc; A Mothes; A Smetz; I Timontin; M D Guardia; A Billiemaz; J Dellamonica; M Vassallo; D Néri; S Chadapaud; A-L Toyer; P Del Guidice; A Fribourg; S Léotard; I Nicolle; P-M Roger Journal: Eur J Clin Microbiol Infect Dis Date: 2015-10-17 Impact factor: 3.267
Authors: Byunghyun Kim; Joonghee Kim; You Hwan Jo; Jae Hyuk Lee; Ji Eun Hwang; Min Ji Park; Sihyung Lee Journal: PLoS One Date: 2018-07-20 Impact factor: 3.240
Authors: Carlos M Luna; Laura Pulido; Michael S Niederman; Alberto Casey; Diego Burgos; Sebastián D Leiva Agüero; Alejandra Grosso; Evangelina Membriani; Andrea C Entrocassi; Marcelo Rodríquez Fermepin; Carlos A Vay; Susana Garcia; Angela Famiglietti Journal: Pneumonia (Nathan) Date: 2018-09-25