Abstract
Background and Objectives. The pneumococcal urinary antigen test (UAT) has superior sensitivity to other investigations in determining the aetiology of community-acquired pneumonia (CAP), but data specific to Australian populations is limited. This study aimed to establish the prevalence and clinical utility of positive UAT in patients admitted to hospital with CAP, as well as associations with positive testing. Methods. A prospective, cross-sectional, single-centre study was performed. Urine antigen tests were performed on all adult patients admitted to hospital with the diagnosis of CAP. Sputum and blood culture results, CURB-65 score of severity, current and prior antibiotics, comorbidities, mortality, and length of hospital stay were recorded. Results. There was a positive test prevalence of 13/170 [7.6% (95% confidence intervals 4.3–13%)]. The overall prevalence of pneumococcal pneumonia was 19/170 (11%), including 8 patients confirmed on positive UAT alone. Patients with a positive UAT result had a higher mean CURB-65 score compared with those with a negative result (P=0.01), and a greater likelihood of requiring intensive care support (P=0.006). Conclusions. The prevalence of positive UAT was low. Positive results were more often recorded in those with greater severity pneumonia. The clinical utility of the test in this cohort of patients was low.
Highlights
Community-acquired pneumonia (CAP) is an important and common disease entity, accounting for more than 100 000 hospital admissions in Australia per year [1]
Background and Objectives. e pneumococcal urinary antigen test (UAT) has superior sensitivity to other investigations in determining the aetiology of community-acquired pneumonia (CAP), but data speci c to Australian populations is limited. is study aimed to establish the prevalence and clinical utility of positive UAT in patients admitted to hospital with CAP, as well as associations with positive testing
All 170 patients admitted to hospital with CAP underwent pneumococcal urine antigen testing (UAT)
Summary
Community-acquired pneumonia (CAP) is an important and common disease entity, accounting for more than 100 000 hospital admissions in Australia per year [1]. E pneumococcal urine antigen test (UAT) has been investigated in both immunocompetent and HIV adult patients hospitalized with CAP, with comparable highstandard performance in both populations [6,7,8,9,10,11,12,13]. Despite its ISRN Infectious Diseases validation as a superior investigation in terms of sensitivity and speci city compared with more conventional microbiological tests, the role of the pneumococcal UAT in evaluating CAP patients remains uncertain, with no clear consensus on when the test should be performed [5, 17, 18]. E primary aims of this study were to establish the prevalence of positive pneumococcal UAT in patients requiring hospital admission for CAP, and to determine the utility of the test both in terms of diagnostic yield, and in uence on management. A secondary aim was to de ne particular patient characteristics associated with test positivity
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