title: Rapid urine antigen testing for Streptococcus pneumoniae in adults with community-acquired pneumonia: clinical use and barriers.
abstract: Streptococcus pneumoniae (pneumococcus) is the most common bacterial etiology of community-acquired pneumonia (CAP) in adults, a leading cause of death. The majority of pneumococcal CAP is diagnosed by blood culture, which likely underestimates the burden of disease. The 2007 CAP guidelines recommend routine use of the rapid pneumococcal urinary antigen (UAg) test. To assess the how pneumococcal UAg testing is being used among hospitalized adult CAP patients and what barriers restrict its use, a Web-based survey was distributed in 2013 to 1287 infectious disease physician members of the Emerging Infectious disease Network of the Infectious Disease Society of America. Of 493 eligible responses, 65% use the pneumococcal UAg test. The primary barrier to UAg use was availability (46%). UAg users reported ordering fewer other diagnostic tests and tailoring antibiotic therapy. Increased access to UAg tests could improve pneumonia management and pneumococcal CAP surveillance.
authors.affiliation: Respiratory Disease Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: ieo9@cdc.gov.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Harris
authors.affiliation: University of Iowa Carver College of Medicine, Iowa City, Iowa.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Beekmann
authors.affiliation: University of Iowa Carver College of Medicine, Iowa City, Iowa.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Moore
mesh_terms: D000942:Antigens, Bacterial / Q000276:immunology* / Q000652:urine*; D017714:Community-Acquired Infections; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D007159:Immunologic Tests; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000652:urine*; D010818:Practice Patterns, Physicians'; D013296:Streptococcus pneumoniae / Q000276:immunology*; D014481:United States / Q000453:epidemiology; D016482:Urinalysis / Q000379:methods
chemical_list: D000942:Antigens, Bacterial
keywords: Community acquired pneumonia; Pneumococcus; Rapid diagnostics; Urine antigen test