Contribution of a Urinary Antigen Assay (Binax NOW) to the Early Diagnosis of Pneumococcal Pneumonia

Rosón, Beatriz; Sabé, N.; Carratalà, Jordi; Verdaguer, Ricard; Dorca, Jordi; Manresa, F.; Gudiol, Francesc

doi:10.1086/380639

Cited by 182 publications

(148 citation statements)

References 15 publications

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“…The specificity was high -89% (IC 95% 80-98), which is also consistent with the data previously described 10,11 . Based on these results, we can state that determining PUatg is useful to confirm the S. pneumoniae etiology.…”

Section: Discussionsupporting

confidence: 92%

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Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia

Ferreira¹,

Abreu²,

Rodrigues³

et al. 2012

IJIM

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Section: Discussionsupporting

confidence: 92%

“…The excretion of antigens may last for several weeks (more than 3 months) after specific antibiotics [6][7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia

Ferreira¹,

Abreu²,

Rodrigues³

et al. 2012

IJIM

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“…18,19 Streptococcus pneumoniae and Legionella pneumophila serogroup 1 antigens in urine were tested by immunochromatography. 20,21 Causative pathogens of pneumonia met one of the following criteria: sputum Gram stain showing phagocytic cells and bacteria equivalent to 10 3 -10 5 colony-forming units (CFU)/ml in sputum culture; >10 6 CFU/ml bacteria in the sputum culture; blood culture-positive; positive urinary pneumococcal or urinary Legionella antigen-test results; positive antibody titers against M. pneumoniae and C. pneumoniae.…”

Section: Microbiological Investigationmentioning

confidence: 99%

Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

et al. 2015

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Objective: To evaluate clinical and microbiological features in patients with nursing and healthcare-associated pneumonia (NHCAP), admitted to the intensive care unit (ICU). Methods: Demographic, clinical and microbiological data were retrospectively reviewed from patients with NHCAP admitted to a respiratory ICU. Patients were categorized into one of four NHCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) hospital discharge in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results: Out of 428 patients reviewed (male, 67.1%; mean age, 71.2 AE 11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8 AE 13.3 days. Mortality rate was not significantly different between the four NHCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO 3 -level, duration of ICU stay, extended spectrum b-lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusion: ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with NHCAP.

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“…The reported sensitivities of the ICT applied on urine samples range from 44.2% to 88.8% (4,5,12,13,14,17). Sensitivities are higher in bacteremic versus nonbacteremic patients and increase when urine samples are concentrated, which is mostly performed by ultracentrifugation and may last for 1 to 4 h (12, 13, 14).…”

Section: Discussionmentioning

confidence: 99%

Detection of Streptococcus pneumoniae Antigen in Bronchoalveolar Lavage Fluid Samples by a Rapid Immunochromatographic Membrane Assay

Jacobs¹,

Stobberingh²,

Cornelissen³

et al. 2005

J Clin Microbiol

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Streptococcus pneumoniae prevails as a leading cause of community-acquired pneumonia (CAP), and it ranks as one of the organisms most commonly involved as the cause of severe CAP requiring intensive care admission (1, 9). Recently, an immunochromatographic membrane test (ICT) for rapid detection of S. pneumoniae antigen (NOW Streptococcus pneumoniae test; Binax, Portland, Maine) has been marketed. Till now, the test has been validated for urine and cerebrospinal fluid samples only. According to the package leaflet of the NOW Streptococcus pneumoniae test, the detection limit of the test in cerebrospinal fluid is 5.10 4 CFU/ml. In our hospital, bronchoscopy with bronchoalveolar lavage (BAL) is used in the diagnosis of severe or nonresolving CAP, ventilator-associated pneumonia (VAP), and pneumonia in immunocompromised patients (7). As the BAL procedure dilutes the lung secretions 10-to 100-fold, a BAL fluid colony count of Ն10 4 CFU/ml represents a bacterial load of Ն10 5 to 10 6 /ml at the collection site, which is indicative of pneumonia (2). As this 10 4 CFU/ml threshold is within reach of the ICT, we were interested in evaluating its performance characteristics when applied on BAL fluid samples obtained in patients with suspected pneumonia. MATERIALS AND METHODSSetting and samples. This retrospective study was conducted at the University Hospital of Maastricht, a 600-bed tertiary care hospital. Bronchoscopy with BAL was performed in patients with suspected pneumonia, including severe or nonresolving CAP, VAP, and pneumonia in immunocompromised patients. To test the sensitivity of the ICT, a group of BAL fluid samples obtained from patients diagnosed as having pneumococcal pneumonia was elected: diagnosis was made by microbiological culture, i.e., growth of S. pneumoniae in blood cultures drawn within 24 h before or after bronchoscopy and/or growth in BAL fluid samples in quantities of Ն10 4 CFU/ml. Specificity and cross-reactions were tested in samples of patients with nonpneumococcal pneumonia, i.e., BAL fluid samples with a clear respiratory pathogen demonstrated (influenza virus, respiratory syncytial virus, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila) or with microorganisms other than S. pneumoniae in quantities of Ն10 4 CFU/ml. Furthermore, a group of BAL fluid samples in which pneumonia was suspected but not microbiologically confirmed were included: in these samples, no respiratory pathogen was detected, and quantitative cultures did not reach the 10 4 CFU/ml threshold level. In some samples belonging to the latter two groups, S. pneumoniae was cultured, although in amounts less than 10 4 CFU/ml. Sampling technique. A fiber-optic bronchoscope (Pentax FB-15H/FB-15X; Pentax Medicals, Tokyo, Japan) was introduced and "wedged" into the affected segmental or subsegmental bronchus. Four aliquots of 50 ml sterile saline (0.9% NaCl, room temperature) were instilled and immediately aspirated and recovered. The BAL fluid samples were transported to the laboratory within 15 min after c...

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Contribution of a Urinary Antigen Assay (Binax NOW) to the Early Diagnosis of Pneumococcal Pneumonia

Cited by 182 publications

References 15 publications

Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia

Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia

Clinical and microbiological features of patients admitted to the intensive care unit with nursing and healthcare-associated pneumonia

Detection of Streptococcus pneumoniae Antigen in Bronchoalveolar Lavage Fluid Samples by a Rapid Immunochromatographic Membrane Assay

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