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Assessment of analysis of urinary pneumococcal antigen by immunochromatography for etiologic diagnosis of community-acquired pneumonia in adults.
Clin Vaccine Immunol. 2006 Oct; 13(10):1092-7.CV

Abstract

The limitations of conventional microbiologic methods (CMM) for etiologic diagnosis of community pneumococcal pneumonia have made faster diagnostic techniques necessary. Our aim was to evaluate the usefulness of the immunochromatography (ICT) technique for detecting urinary Streptococcus pneumoniae antigen in the etiologic diagnosis of community-acquired pneumonias (CAP). This was a prospective study on in-patients with CAP in a tertiary hospital conducted from October 2000 to March 2004. Apart from using CMM to reach an etiologic diagnosis, we determined pneumococcal antigen in concentrated urine by ICT. We also determined the urinary pneumococcal antigen (UPA) content in patients from two control groups to calculate the specificity of the technique. One group was comprised of in-patients diagnosed with chronic obstructive pulmonary disease (COPD) or asthma, with respiratory infection, and without pneumonia; the other group included fractures. We studied 959 pneumonia patients and determined UPA content in 911 (95%) of them. We diagnosed the etiology of 253 cases (28%) using CMM; S. pneumoniae was the most common etiologic agent (57 cases). ICT analysis was positive for 279 patients (31%). Using this technique, the percentage of diagnoses of pneumococcal pneumonias increased by 26%, while the overall etiologic diagnosis increased from 28 to 49%. The technique sensitivity was 81%; the specificity oscillated between 80% in CAP with nonpneumococcal etiology and 99% for patients with fractures without infections. Determination of UPA is a rapid, simple analysis with good sensitivity and specificity, which increased the percentage of etiologic diagnoses. Positive UPA may persist in COPD patients with probable pneumococcal colonization or recent pneumococcal infections.

Authors+Show Affiliations

Pneumology Department, Respiratory Intensive Care Unit, Hospital Clínico Universitario, Universitat de Valencia, Spain. marisabriones@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17028212

Citation

Briones, Maria Luisa, et al. "Assessment of Analysis of Urinary Pneumococcal Antigen By Immunochromatography for Etiologic Diagnosis of Community-acquired Pneumonia in Adults." Clinical and Vaccine Immunology : CVI, vol. 13, no. 10, 2006, pp. 1092-7.
Briones ML, Blanquer J, Ferrando D, et al. Assessment of analysis of urinary pneumococcal antigen by immunochromatography for etiologic diagnosis of community-acquired pneumonia in adults. Clin Vaccine Immunol. 2006;13(10):1092-7.
Briones, M. L., Blanquer, J., Ferrando, D., Blasco, M. L., Gimeno, C., & Marín, J. (2006). Assessment of analysis of urinary pneumococcal antigen by immunochromatography for etiologic diagnosis of community-acquired pneumonia in adults. Clinical and Vaccine Immunology : CVI, 13(10), 1092-7.
Briones ML, et al. Assessment of Analysis of Urinary Pneumococcal Antigen By Immunochromatography for Etiologic Diagnosis of Community-acquired Pneumonia in Adults. Clin Vaccine Immunol. 2006;13(10):1092-7. PubMed PMID: 17028212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of analysis of urinary pneumococcal antigen by immunochromatography for etiologic diagnosis of community-acquired pneumonia in adults. AU - Briones,Maria Luisa, AU - Blanquer,José, AU - Ferrando,David, AU - Blasco,Maria Luisa, AU - Gimeno,Concepción, AU - Marín,Julio, PY - 2006/10/10/pubmed PY - 2007/1/9/medline PY - 2006/10/10/entrez SP - 1092 EP - 7 JF - Clinical and vaccine immunology : CVI JO - Clin Vaccine Immunol VL - 13 IS - 10 N2 - The limitations of conventional microbiologic methods (CMM) for etiologic diagnosis of community pneumococcal pneumonia have made faster diagnostic techniques necessary. Our aim was to evaluate the usefulness of the immunochromatography (ICT) technique for detecting urinary Streptococcus pneumoniae antigen in the etiologic diagnosis of community-acquired pneumonias (CAP). This was a prospective study on in-patients with CAP in a tertiary hospital conducted from October 2000 to March 2004. Apart from using CMM to reach an etiologic diagnosis, we determined pneumococcal antigen in concentrated urine by ICT. We also determined the urinary pneumococcal antigen (UPA) content in patients from two control groups to calculate the specificity of the technique. One group was comprised of in-patients diagnosed with chronic obstructive pulmonary disease (COPD) or asthma, with respiratory infection, and without pneumonia; the other group included fractures. We studied 959 pneumonia patients and determined UPA content in 911 (95%) of them. We diagnosed the etiology of 253 cases (28%) using CMM; S. pneumoniae was the most common etiologic agent (57 cases). ICT analysis was positive for 279 patients (31%). Using this technique, the percentage of diagnoses of pneumococcal pneumonias increased by 26%, while the overall etiologic diagnosis increased from 28 to 49%. The technique sensitivity was 81%; the specificity oscillated between 80% in CAP with nonpneumococcal etiology and 99% for patients with fractures without infections. Determination of UPA is a rapid, simple analysis with good sensitivity and specificity, which increased the percentage of etiologic diagnoses. Positive UPA may persist in COPD patients with probable pneumococcal colonization or recent pneumococcal infections. SN - 1556-6811 UR - https://www.unboundmedicine.com/medline/citation/17028212/Assessment_of_analysis_of_urinary_pneumococcal_antigen_by_immunochromatography_for_etiologic_diagnosis_of_community_acquired_pneumonia_in_adults_ L2 - http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=17028212 DB - PRIME DP - Unbound Medicine ER -