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[Assessment of the contribution of the immunochromatographic pneumococcal urinary antigen test to the etiological diagnosis of pneumonia in hospitalized adults].
Pathol Biol (Paris). 2010 Apr; 58(2):117-22.PB

Abstract

AIM OF THE STUDY

To assess the usefulness and prescription practices of the Binax Now Streptococcus pneumoniae urinary antigen test in hospitalized adults.

PATIENTS AND METHODS

The results of the pneumococcal urinary antigen tests (UAT) performed from January 2002 to September 2004 were related to that of microbiological cultures, and in positive patients to radiographic findings and C-reactive protein (CRP) levels. The evolution of the number of prescriptions and positivity rate in 2007 versus 2002-2004 was analyzed.

RESULTS

The pneumococcal UAT was positive in 32 of the 278 patients included from 2002 to 2004 (11.5%). Results were concordant with that of microbiological cultures in 90% of the 247 documented cases. Pneumococcal etiology was considered to be definite in 19 patients (isolation of S. pneumoniae from blood, 17 patients; or pleural fluid, two patients), of whom 15 had a positive UAT (sensitivity: 79%); to be probable in 22 patients (positive UAT, 17 patients and/or isolation of S. pneumoniae from respiratory samples, six patients), and was retained in 39 of the 41 patients (positive predictive value: 93.7%). CRP was greater than 100mg/L in 34 of 39 documented patients and lobar alveolar radiographic opacities observed in 25 of 28 documented patients. In 2007, the dramatic increase in the number of UAT prescriptions and the diversification of prescribing units were associated to a decreased positivity rate (8.1%).

CONCLUSION

Whereas the pneumococcal UAT clearly increases etiological diagnosis, pneumococcal pneumonia cannot be ruled out if negative. Indications for its use need to be refined to improve the cost-effectiveness of this test.

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Publisher Full Text

Authors+Show Affiliations

Segonds C
Laboratoire de bactériologie-hygiène, institut fédératif de biologie, hôpital Purpan, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse cedex 9, France. segonds.c@chu-toulouse.fr
Le Goff A
No affiliation info available
Chabanon G
No affiliation info available

MeSH

AdultAgedAnti-Bacterial AgentsBacteremiaBacteriuriaColorimetryCommunity-Acquired InfectionsEarly DiagnosisFemaleHumansImmunosorbent TechniquesMaleMiddle AgedPleural EffusionPneumonia, PneumococcalPolysaccharides, BacterialReagent Kits, DiagnosticRetrospective StudiesSensitivity and SpecificityStreptococcus pneumoniaeYoung Adult

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

fre

PubMed ID

19875240

Citation

Segonds, C, et al. "[Assessment of the Contribution of the Immunochromatographic Pneumococcal Urinary Antigen Test to the Etiological Diagnosis of Pneumonia in Hospitalized Adults]." Pathologie-biologie, vol. 58, no. 2, 2010, pp. 117-22.
Segonds C, Le Goff A, Chabanon G. [Assessment of the contribution of the immunochromatographic pneumococcal urinary antigen test to the etiological diagnosis of pneumonia in hospitalized adults]. Pathol Biol (Paris). 2010;58(2):117-22.
Segonds, C., Le Goff, A., & Chabanon, G. (2010). [Assessment of the contribution of the immunochromatographic pneumococcal urinary antigen test to the etiological diagnosis of pneumonia in hospitalized adults]. Pathologie-biologie, 58(2), 117-22. https://doi.org/10.1016/j.patbio.2009.07.037
Segonds C, Le Goff A, Chabanon G. [Assessment of the Contribution of the Immunochromatographic Pneumococcal Urinary Antigen Test to the Etiological Diagnosis of Pneumonia in Hospitalized Adults]. Pathol Biol (Paris). 2010;58(2):117-22. PubMed PMID: 19875240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Assessment of the contribution of the immunochromatographic pneumococcal urinary antigen test to the etiological diagnosis of pneumonia in hospitalized adults]. AU - Segonds,C, AU - Le Goff,A, AU - Chabanon,G, Y1 - 2009/10/28/ PY - 2009/07/10/received PY - 2009/07/21/accepted PY - 2009/10/31/entrez PY - 2009/10/31/pubmed PY - 2010/8/13/medline SP - 117 EP - 22 JF - Pathologie-biologie JO - Pathol Biol (Paris) VL - 58 IS - 2 N2 - AIM OF THE STUDY: To assess the usefulness and prescription practices of the Binax Now Streptococcus pneumoniae urinary antigen test in hospitalized adults. PATIENTS AND METHODS: The results of the pneumococcal urinary antigen tests (UAT) performed from January 2002 to September 2004 were related to that of microbiological cultures, and in positive patients to radiographic findings and C-reactive protein (CRP) levels. The evolution of the number of prescriptions and positivity rate in 2007 versus 2002-2004 was analyzed. RESULTS: The pneumococcal UAT was positive in 32 of the 278 patients included from 2002 to 2004 (11.5%). Results were concordant with that of microbiological cultures in 90% of the 247 documented cases. Pneumococcal etiology was considered to be definite in 19 patients (isolation of S. pneumoniae from blood, 17 patients; or pleural fluid, two patients), of whom 15 had a positive UAT (sensitivity: 79%); to be probable in 22 patients (positive UAT, 17 patients and/or isolation of S. pneumoniae from respiratory samples, six patients), and was retained in 39 of the 41 patients (positive predictive value: 93.7%). CRP was greater than 100mg/L in 34 of 39 documented patients and lobar alveolar radiographic opacities observed in 25 of 28 documented patients. In 2007, the dramatic increase in the number of UAT prescriptions and the diversification of prescribing units were associated to a decreased positivity rate (8.1%). CONCLUSION: Whereas the pneumococcal UAT clearly increases etiological diagnosis, pneumococcal pneumonia cannot be ruled out if negative. Indications for its use need to be refined to improve the cost-effectiveness of this test. SN - 1768-3114 UR - https://www.unboundmedicine.com/medline/citation/19875240/[Assessment_of_the_contribution_of_the_immunochromatographic_pneumococcal_urinary_antigen_test_to_the_etiological_diagnosis_of_pneumonia_in_hospitalized_adults]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0369-8114(09)00175-8 DB - PRIME DP - Unbound Medicine ER -