Andreo Felipe, Domínguez José, Ruiz Juan, Blanco Silvia, Arellano Elisabet, Prat Cristina, Morera Josep, Ausina Vicente
Department of Pneumology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Respir Med. 2006 May;100(5):884-91. doi: 10.1016/j.rmed.2005.08.020. Epub 2005 Oct 12.
To evaluate the rapid urine antigen tests, including a new rapid immunochromatographic test (ICT) for the detection of the Streptococcus pneumoniae antigen and an enzyme immunoassay (EIA) for the detection of the Legionella antigen, in order to improve the diagnosis of community-acquired pneumonia (CAP) in adults.
Prospective study.
A tertiary hospital in Spain.
We consecutively recruited 107 adults with CAP evaluated at our hospital.
The analyses included blood and sputum cultures, pleural fluid culture (if present) and serologic studies. The detection of the Legionella pneumophila urinary antigen was performed by EIA, and the detection of S. pneumoniae antigen in urine samples was performed by counterimmunoelectrophoresis (CIE) and a rapid ICT.
Using conventional microbiologic tests we succeeded in performing the etiologic diagnosis of 39 out of the 107 cases (36.4%). The inclusion of rapid antigen detection techniques increased the percentage of diagnosis to 54.2%, which represents a total increase of 17.8% (P=0.034).
The data obtained in this study indicate that rapid urine antigen tests are very useful to determine CAP etiology in adults and, consequently, to quickly identify a group of patients in whom narrow spectrum antibiotics may be used.
评估快速尿液抗原检测，包括一种用于检测肺炎链球菌抗原的新型快速免疫层析试验（ICT）和一种用于检测军团菌抗原的酶免疫测定（EIA），以改善成人社区获得性肺炎（CAP）的诊断。
前瞻性研究。
西班牙一家三级医院。
我们连续招募了107例在我院接受评估的成人CAP患者。
分析包括血液和痰液培养、胸腔积液培养（如有）以及血清学研究。通过EIA检测嗜肺军团菌尿液抗原，通过对流免疫电泳（CIE）和快速ICT检测尿液样本中的肺炎链球菌抗原。
使用传统微生物学检测方法，我们成功对107例病例中的39例（36.4%）进行了病因诊断。纳入快速抗原检测技术后，诊断百分比提高到54.2%，总体提高了17.8%（P=0.034）。
本研究获得的数据表明，快速尿液抗原检测对于确定成人CAP病因非常有用，因此可以快速识别出一组可能使用窄谱抗生素的患者。
