Examination about utility of a Streptococcus pneumoniae capsular antigen swiftness search kit urine in a pneumonia patient

• Published in: Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology Vol. 16; no. 2; p. 153
• Main Authors: Hashikita, Giichi, Yamaguti, Toshiyuki, Tachi, Yoshimi, Kishi, Etsuko, Kawamura, Toru, Takahashi, Shun, Arai, Yukie, Koyama, Sachie, Huruhata, Toshihumi, Itabashi, Akira, Oka, Yoko, Yamazaki, Tsutomu, Maesaki, Sigefumi
• Format: Journal Article
• Language: Japanese
• Published: Japan 2005
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, Bacterial - urine; Bacterial Capsules - immunology; Bacteriological Techniques - instrumentation; Humans; Middle Aged; Pneumonia, Pneumococcal - immunology; Sensitivity and Specificity; Streptococcus pneumoniae - immunology
• ISSN: 0915-1753

We investigated the usefullness of Binax NOW urine antigen test, an immunochromatographic assay that binds any soluble Streptococcus pneumoniae antigen (C polysaccharide) for the diagnosis of penumoniae form September 2003 to March 2005. We used 372 samples form the patinets with pneumoniae diagnosed for blood or sputum cultuter or gram-stained sputum smear. Out of 24 culture positive specimens, Binax NOW urine antigen test, showed positive in 18 (75%) specimens. The sensitivity of sputum and blood culture was 71.7% and 83.3%, respectively. Binax NOW urine antigen test was seemed false positives in 55 samples, false negatives in 6 samples. The specificity of Binax NOW urine antigen test was evaluated 84.1%. Overall agreement among tests was 83.6%. When compared to culture, false negative urine antigen may be the result of colonizing S. pneumoniae in sputum or pneumonia caused by an agent other than S. pneumoniae. CRP values for cases were both urine antigen and culture were positive ranged from 40 mg/dl to 10 mg/dl while urine antigen and culture negative cases were predominantly less than 10 mg/dl. Positive blood and pleural fluid culture cases were consistently associated with strongly positive urine antigen tests. Non-agreement between urine antigen, culture, and microscopy may be the result of specimen quality, labile nature of S. pneumoniae and antimicrobial therapy.