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Rapid urinary antigen test for diagnosis of pneumococcal community-acquired pneumonia in adults

M A Marcos1, M T Jiménez de Anta, J P de la Bellacasa

  • 1Dept of Microbiology, Institute of Infections and Immunology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain.

The European Respiratory Journal
|March 1, 2003
PubMed

Insights

A new urine test accurately detects Streptococcus pneumoniae, a common cause of community-acquired pneumonia (CAP). This rapid immunochromatographic test (ICT) shows high sensitivity and specificity in diagnosing pneumococcal pneumonia.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Diagnostic Medicine

Background:

  • Streptococcus pneumoniae is a significant cause of community-acquired pneumonia (CAP).
  • Conventional diagnostic methods often fail to identify the specific etiology of CAP.
  • Urine antigen detection offers a potential diagnostic avenue for pneumococcal pneumonia.

Purpose of the Study:

  • To evaluate the diagnostic performance of a new immunochromatographic membrane test (ICT) for detecting S. pneumoniae antigen in urine.
  • To assess the ICT's utility in patients with diagnosed CAP, including those with human immunodeficiency virus type 1 (HIV-1) infection.
  • To determine the persistence of ICT positivity after hospital discharge.

Main Methods:

  • The study involved patients admitted with diagnosed CAP.
  • An immunochromatographic membrane test (ICT) was performed on unconcentrated and concentrated urine samples.
  • The ICT was repeated one month post-discharge in a subset of patients and tested in stable HIV-1 infected individuals.

Main Results:

  • S. pneumoniae antigen was detected in 100% of definitive pneumococcal pneumonia cases.
  • The ICT showed positive results in 69.2% of probable pneumococcal pneumonia cases and 18% of non-pneumococcal pneumonia cases.
  • The test remained positive in 69.5% of patients one month after discharge; no ICT positivity was found in HIV-1 infected patients with nasopharyngeal colonization.

Conclusions:

  • The Binax NOW ICT is a rapid, sensitive, and specific diagnostic tool for adult pneumococcal CAP.
  • The ICT can detect S. pneumoniae antigen in urine, aiding in the diagnosis of pneumonia.
  • The test may remain positive for several weeks post-pneumonia, a factor to consider in interpretation.

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