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[Contribution of urinary pneumococcal antigen detection combined with the research of legionella antigen for diagnosis of pneumonia in hospitalized patients].
Pathol Biol (Paris). 2004 Oct; 52(8):429-33.PB

Abstract

AIM OF THE STUDY

Bacteriological confirmation of pneumonia (PNM) in hospitalized patients is often erratic or belated. Because of importance of prognosis, early adaptation of treatment requires an empirical antimicrobial therapy (generally aminopenicillin and macrolide combination). The starting therapeutic strategy should profit by a fast and reliable test asserting a pneumococcal etiology. The Binax Now S. pneumoniae (BNP) test allows an urinary pneumococcal antigen (UPA) detection using an immunochromatographic membrane assay within 15 minutes.

MATERIALS AND METHODS

We first evaluated the BNP test for 28 patients with pneumococcal PNM proved by culture, and 118 negative control patients without PNM. The BNP test was then evaluated by testing urine from 158 hospitalized patients with a clinical picture of PNM (community-acquired: 90, nosocomial: 68) for whom a research of urinary Legionella antigen (Binax Now) was prescribed and was positive for only two cases. 57 patients (36.1%) were hospitalized in ICU.

RESULTS

The sensitivity was 71.4% (85.7% for the 21 bacteriemic PNM), and the specificity was 98.3%; that is consistent with previous published data. Among the 158 patients with PNM, UPA was detected in 17 cases (10.8%): 15 within the community-acquired PNM (16.7%) and 2 (2.9%) within the nosocomial cases. The pneumococcal etiology was confirmed by bacteriological samples in 7/17 patients (6 by blood cultures). The 10 others showed clinical and radiological features in agreement with a pneumococcal PNM. Among the 141 patients with negative AUP, S. pneumoniae was isolated from 6 of them (2 in blood cultures).

CONCLUSION

The Binax Now S. pneumoniae test allowed a fast and reliable etiological diagnosis in 10.8% of hospitalized PNM (16.7% of the community-acquired cases) having a research of urinary Legionella antigen (conceiving with severity factors). So it could conduce to an improved adjustment of the starting antimicrobial therapy of hospitalized adult patients with PNM.

Authors+Show Affiliations

Laboratoire de microbiologie-virologie-hygiène, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

15465259

Citation

Honoré, S, et al. "[Contribution of Urinary Pneumococcal Antigen Detection Combined With the Research of Legionella Antigen for Diagnosis of Pneumonia in Hospitalized Patients]." Pathologie-biologie, vol. 52, no. 8, 2004, pp. 429-33.
Honoré S, Trillard M, Ould-Hocine Z, et al. [Contribution of urinary pneumococcal antigen detection combined with the research of legionella antigen for diagnosis of pneumonia in hospitalized patients]. Pathol Biol (Paris). 2004;52(8):429-33.
Honoré, S., Trillard, M., Ould-Hocine, Z., Lesprit, P., Deforges, L., & Legrand, P. (2004). [Contribution of urinary pneumococcal antigen detection combined with the research of legionella antigen for diagnosis of pneumonia in hospitalized patients]. Pathologie-biologie, 52(8), 429-33.
Honoré S, et al. [Contribution of Urinary Pneumococcal Antigen Detection Combined With the Research of Legionella Antigen for Diagnosis of Pneumonia in Hospitalized Patients]. Pathol Biol (Paris). 2004;52(8):429-33. PubMed PMID: 15465259.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Contribution of urinary pneumococcal antigen detection combined with the research of legionella antigen for diagnosis of pneumonia in hospitalized patients]. AU - Honoré,S, AU - Trillard,M, AU - Ould-Hocine,Z, AU - Lesprit,P, AU - Deforges,L, AU - Legrand,P, PY - 2004/07/02/received PY - 2004/07/15/accepted PY - 2004/10/7/pubmed PY - 2004/12/31/medline PY - 2004/10/7/entrez SP - 429 EP - 33 JF - Pathologie-biologie JO - Pathol Biol (Paris) VL - 52 IS - 8 N2 - AIM OF THE STUDY: Bacteriological confirmation of pneumonia (PNM) in hospitalized patients is often erratic or belated. Because of importance of prognosis, early adaptation of treatment requires an empirical antimicrobial therapy (generally aminopenicillin and macrolide combination). The starting therapeutic strategy should profit by a fast and reliable test asserting a pneumococcal etiology. The Binax Now S. pneumoniae (BNP) test allows an urinary pneumococcal antigen (UPA) detection using an immunochromatographic membrane assay within 15 minutes. MATERIALS AND METHODS: We first evaluated the BNP test for 28 patients with pneumococcal PNM proved by culture, and 118 negative control patients without PNM. The BNP test was then evaluated by testing urine from 158 hospitalized patients with a clinical picture of PNM (community-acquired: 90, nosocomial: 68) for whom a research of urinary Legionella antigen (Binax Now) was prescribed and was positive for only two cases. 57 patients (36.1%) were hospitalized in ICU. RESULTS: The sensitivity was 71.4% (85.7% for the 21 bacteriemic PNM), and the specificity was 98.3%; that is consistent with previous published data. Among the 158 patients with PNM, UPA was detected in 17 cases (10.8%): 15 within the community-acquired PNM (16.7%) and 2 (2.9%) within the nosocomial cases. The pneumococcal etiology was confirmed by bacteriological samples in 7/17 patients (6 by blood cultures). The 10 others showed clinical and radiological features in agreement with a pneumococcal PNM. Among the 141 patients with negative AUP, S. pneumoniae was isolated from 6 of them (2 in blood cultures). CONCLUSION: The Binax Now S. pneumoniae test allowed a fast and reliable etiological diagnosis in 10.8% of hospitalized PNM (16.7% of the community-acquired cases) having a research of urinary Legionella antigen (conceiving with severity factors). So it could conduce to an improved adjustment of the starting antimicrobial therapy of hospitalized adult patients with PNM. SN - 0369-8114 UR - https://www.unboundmedicine.com/medline/citation/15465259/[Contribution_of_urinary_pneumococcal_antigen_detection_combined_with_the_research_of_legionella_antigen_for_diagnosis_of_pneumonia_in_hospitalized_patients]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0369-8114(04)00173-7 DB - PRIME DP - Unbound Medicine ER -