title: Evaluation of a rapid test for the diagnosis of pneumococcal pneumonia.
abstract: We evaluated the usefulness of a rapid immunochromatographic pneumococcal urinary antigen test (UAT) for the diagnosis of pneumonia over a period of five years. The UAT was positive in 32 (2.3%) urine samples obtained from 1414 patients. In 46 of these 1414 patients results of UAT and/or sputum/pleural fluid culture and/or blood culture and/or procalcitonin levels were available and therefore the study was concentrated on these patients. A concordance between UAT positivity and the presence of Streptococcus pneumoniae in the sputum was observed in only 4 of 46 (8.7%) patients for which both urine and sputum samples were analyzed. A discordant result (UAT positive and absence of S. pneumoniae in sputum samples) was recorded in 8 of 46 (17.4 %) patients. UAT negative results with sputum culture positive for S. pneumoniae were recorded in 28.3% of patients. In 20 patients, UAT tested positive but sputum culture was not performed. A concordance between UAT positivity and the isolation of S. pneumoniae from blood was seen in 2 of 46 patients whereas a discordant result (UAT positive and blood culture negative) was seen in 12 (26.1%) patients. A concordance between the UAT and high levels (≥2ng/ml) of procalcitonin was observed in 4 out of 46 patients, whereas a positive UAT result and a procalcitonin negative result were observed in 2 patients. In our experience the UAT allows the detection of the etiological agent of pneumonia, and also when sputum and/or blood cultures are negative for S. pneumoniae, when the clinical picture is suggestive of alveolar pneumonia.
authors.affiliation: Department of Basic Medical Sciences, University of Bari Aldo Moro, Policlinico, p.zza G. Cesare 11, 70124 Bari, Italy. rosa.monno@uniba.it
authors.forename: R
authors.initials: R
authors.lastname: Monno
authors.forename: L
authors.initials: L
authors.lastname: Fumarola
authors.forename: G
authors.initials: G
authors.lastname: Mercadante
authors.forename: G
authors.initials: G
authors.lastname: Tzakis
authors.forename: M
authors.initials: M
authors.lastname: Battista
authors.forename: G
authors.initials: G
authors.lastname: Miragliotta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000032:analysis; D001431:Bacteriological Techniques / Q000379:methods*; D002846:Chromatography, Affinity / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis*; D012189:Retrospective Studies; D013183:Sputum / Q000737:chemistry; D014556:Urine / Q000737:chemistry; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial