Evaluating the use of a Streptococcus pneumoniae urinary antigen detection kit for the management of community-acquired pneumonia in Japan.
BACKGROUND
The urinary antigen detection kit for Streptococcus pneumoniae was tested.


OBJECTIVE
It was our aim to evaluate the usefulness of the immunochromatographic membrane test by doing a large prospective study of community-acquired pneumonia (CAP) in Japan.


METHODS
We prospectively evaluated the use of the S. pneumoniae urinary antigen detection kit and analyzed the treatment and clinical effect seen in patients with positive test kit results. One hundred and fifty-six patients with CAP admitted to our hospital between October 2001 and September 2003 were evaluated.


RESULTS
In 49% of these CAP patients, the causative microorganisms were isolated. S. pneumoniae was suspected to be the causative microorganism in 15%, but positive results of the urinary antigen detection kit indicated S. pneumoniae to be a probable microorganism in 28%, even though antibiotics had previously been administered to half of the patients. The kit was particularly useful for diagnosing patients with poor quality sputum in whom antibiotics treatment nevertheless had to be selected. Antibiotics appropriate for S. pneumoniae (mainly penicillin) were given. The treatment was found to have excellent clinical results in 89% of the CAP patients.


CONCLUSIONS
The S. pneumoniae urinary antigen detection kit was considered to be useful in selecting treatment since there was a high level of clinical effectiveness when the most suitable antibiotics were immediately administered to positive patients. The use of the S. pneumoniae urinary antigen kit is rapid and simple compared with conventional microbiological procedures.
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Kurashiki, Japan. yoshihiro@med.kawasaki-m.ac.jp
Yoshihiro
Y
Kobashi
Kouichiro
K
Yoshida
Naoyuki
N
Miyashita
Yoshihito
Y
Niki
Toshiharu
T
Matsushima
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000652:urine*; D001431:Bacteriological Techniques / Q000295:instrumentation; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D015995:Prevalence; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000276:immunology* / Q000302:isolation & purification
D000942:Antigens, Bacterial