title: Evaluation of the immunochromatographic Binax NOW assay for detection of Streptococcus pneumoniae urinary antigen in a prospective study of community-acquired pneumonia in Spain.
abstract: We evaluated the Binax NOW rapid immunochromatographic membrane test (ICT) for detection of Streptococcus pneumoniae urinary antigen in a population-based prospective study of adults with community-acquired pneumonia (CAP). ICT was performed with urine samples obtained from 452 (91.7%) of 493 patients enrolled. Pneumococcal antigen was detected in 19 (70.4%) of 27 patients with pneumococcal pneumonia. The test results were more frequently positive for patients who had not received antibiotics before testing (26.6% vs. 12.1%; P=.002). Only 16 (10.3%) of 156 samples obtained from patients with nonpneumococcal pneumonia yielded a positive result. Of the 269 patients who had pneumonia with no pathogen identified, antigen was detected in 69 (25.7%). With conventional microbiological criteria used as the "gold standard," the test had a sensitivity of 70.4% and a specificity of 89.7%. Testing concentrated urine samples with the ICT may be a useful technique for rapid diagnosis of pneumococcal pneumonia in adults with CAP.
authors.affiliation: Infectious Diseases Unit, Internal Medicine Department, Hospital General Universitario de Elche, Alicante, Spain. gutierrez_fel@gva.es
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: Mar
authors.initials: M
authors.lastname: Masiá
authors.forename: J Carlos
authors.initials: JC
authors.lastname: Rodríguez
authors.forename: Antonio
authors.initials: A
authors.lastname: Ayelo
authors.forename: Bernardo
authors.initials: B
authors.lastname: Soldán
authors.forename: Laura
authors.initials: L
authors.lastname: Cebrián
authors.forename: Carlos
authors.initials: C
authors.lastname: Mirete
authors.forename: Gloria
authors.initials: G
authors.lastname: Royo
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Hidalgo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000652:urine*; D002845:Chromatography; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000382:microbiology*; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D000942:Antigens, Bacterial; D011933:Reagent Kits, Diagnostic