Evaluation of the Binax NOW Streptococcus pneumoniae urinary antigen assay in intensive care patients hospitalized for pneumonia.
OBJECTIVE
To evaluate the diagnostic performance of Binax Now S. pneumoniae urinary antigen rapid immunochromatographic membrane test (ICT) for patients with suspicion of community-acquired pneumonia hospitalized in intensive care and to assess the impact of prior antibiotics on its diagnostic performance.


METHODS
Retrospective study in a medicosurgical ICU in a 700-bed general hospital.


METHODS
Charts of patients with ICT performed (result blinded) were reviewed between May 2002 and July 2004. ICT has been performed in 140 of the 1,006 patients hospitalized in the unit; two-thirds had received antibiotics prior to admission.


RESULTS
Diagnosis of pneumonia was made according to usual criteria. All patients had at least one microbiological test. Pneumonia diagnosis confirmed in 108 patients including 32 pneumococcal. ICT was positive in 23 of 32 patients with pneumococcal pneumonia, in 11 of 108 without, and in none of the 32 patients without pneumonia, resulting in sensitivity, specificity, and positive and negative predictive values of, respectively: 72%, 90%, 68% and 92%. Positive likelihood ratios were comparable among patients with or without prior antibiotics (respectively 6 and 12 for 7 in the overall population).


CONCLUSIONS
This first clinical evaluation of ICT in intensive care patients hospitalized for suspicion of community-acquired pneumonia, demonstrated performance in accordance with published data even in the case of prior antibiotics. Its clinical interest and impact on antibiotics policy remain to be refined.
Lasocki
Sigismond
S
Service de Réanimation Chirurgicale, CHU Bichat-Claude Bernard, 46 rue Henri Huchard, 75877, Paris Cedex 18, France. sigismond@lasocki.com
Scanvic
Agnès
A
Le Turdu
Françoise
F
Restoux
Aymeric
A
Mentec
Hervé
H
Bleichner
Gérard
G
Sollet
Jean-Pierre
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000942:Antigens, Bacterial / Q000652:urine; D002845:Chromatography / Q000379:methods; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial