Evaluation of pneumococcal urinary antigen testing for respiratory tract infection investigations

• Published in: Médecine et maladies infectieuses 2020-02, Vol.50 (1), p.57-62
• Main Authors: Charton, F., Conan, P.L., Le Floch, H., Bylicki, O., Gaspard, W., Soler, C., Margery, J., Rivière, F.
• Format: Article
• Language: English
• Subjects: Aged; Alveoli; Antigens; Antigens, Bacterial - urine; Antigénurie pneumocoque; Cough; Epidemiology; Female; Fever; Humans; Immunosuppression; Immunosuppressive agents; Infection respiratoire; Infections; Male; Middle Aged; Pneumococcal urinary antigen; Pneumocoque; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Pneumococcal - microbiology; Pneumonia, Pneumococcal - urine; Respiratory tract; Respiratory tract diseases; Respiratory tract infection; Respiratory Tract Infections - diagnosis; Respiratory Tract Infections - microbiology; Respiratory Tract Infections - urine; Retrospective Studies; Severity of Illness Index; Signs and symptoms; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Test procedures
• ISSN: 0399-077X; 1769-6690
• DOI: 10.1016/j.medmal.2019.06.009

•This study evaluated the use of pneumococcal urinary antigen testing for the diagnosis of lower respiratory tract infections, and identified factors associated with positive results to this test. To our knowledge this was the first study to assess the association between the pneumococcal urinary antigen test result and clinical, biological, and radiological data in real life. This study is a first step in the research for well-reasoned prescription of pneumococcal urinary antigen test to reduce prescriptions and cost. The pneumococcal urinary antigen test enables rapid bacteriological diagnosis in respiratory tract infections. The objective was to identify factors associated with a positive pneumococcal urinary antigen test result. This seven-year retrospective monocentric study was performed on consecutive patients presenting with respiratory tract infections reported as pneumococcal-positive. Epidemiological, biological, and radiological factors were analyzed, and severity scores were calculated. A total of 223 patients were included. Significant associations were observed between positive test results and age over 65years (P=0.01), positive test results and immunosuppression factors (blood disease [25% Ag+ group vs. 4% Ag− group, P=0.001], immunosuppressive therapy [10% Ag+ group vs. 0% Ag− group, P=0.02]). Clinically, fever (64% Ag+ group vs. 42% Ag− group, P=0.01) and cough (46% Ag+ group vs. 19% Ag− group, P