Urgent pneumococcal urinary antigen, importance in the diagnosis of acquired pneumonia in HIV-1 patients.
The aim of our study was to determine the usefulness of pneumococcal urinary antigen (UA) collected in the emergency department (ED) for the microbiologic diagnosis of community-acquired pneumonia (CAP) in HIV patients and to compare it with other diagnostic tests. Prospective study from 1 January 2007 to 31 December 2008 included HIV-infected patients admitted at the ED with respiratory symptoms and who were diagnosed of CAP. UA, two blood cultures and sputum sample for culture determination were collected from every patient. Sixty-four patients were included. The mean age was 42 years. A total of 31 (48%) UA tests, 12 (19%) blood cultures and 21 (33%) sputum cultures tested positive. A microbiological diagnosis was obtained in 38 (59%) cases. Pneumococcal pneumonia was diagnosed in 32 cases. The statistical analysis showed that the test with best performance was the UA, both in relation to blood and sputum cultures (P<0.05). Two patients died during hospitalization (series mortality of 3%). In conclusion, given its good diagnostic performance, UA should be requested in the ED for the aetiological diagnosis of CAP.
aDepartments of Emergency bMicrobiology cInfectious Diseases, Hospital Clinic, Barcelona, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
Rafael
R
Perelló
Oscar
O
Miró
José M
JM
Miró
Elisabeth
E
Massó
Miquel
M
Sánchez
Silvia
S
Camón
Jordi Puig
JP
de la Bellacasa
Asunción
A
Moreno
María
M
de Los Angeles Marcos
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine; D000328:Adult; D000942:Antigens, Bacterial / Q000652:urine*; D001431:Bacteriological Techniques / Q000379:methods; D001769:Blood / Q000382:microbiology; D017714:Community-Acquired Infections / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine; D004635:Emergency Medicine; D005260:Female; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D013030:Spain; D013183:Sputum / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
D000942:Antigens, Bacterial