Genné Daniel, Siegrist Hans H, Lienhard Reto
Service de Médecine Interne de l'Hôpital de la Ville, rue du Chasseral 20, 2300 La Chaux-de-Fonds, Switzerland.
Int J Infect Dis. 2006 Mar;10(2):124-8. doi: 10.1016/j.ijid.2005.03.006. Epub 2005 Nov 10.
Approximately 40% of community-acquired pneumonia (CAP) remains of unknown etiology. To improve the rate of detection of the causative microbiologic agent, the Binax NOW Streptococcus pneumoniae urinary antigen test (UAT) was evaluated.
In this prospective study, 67 adults with CAP were compared with 81 healthy patients to determine sensitivity and specificity of the UAT and its role in improving the etiologic diagnosis of CAP.
An etiology could be found for 22 patients (33%) using conventional methods (14 S. pneumoniae, sensitivity 64.3%, 1/81 positive UAT control urine samples, specificity 98.8%). This proportion increased to 33 patients (49%) with the addition of the urinary antigen test (p = 0.039). Pneumococcal infection was diagnosed by the UAT in 24% of our patients without an etiologic identification by conventional methods.
Given its excellent specificity, this test can be considered an important tool for detecting S. pneumoniae in CAP of unknown etiology, enabling the diagnosis of pneumococcal pneumonia in a quarter of cases.
约40%的社区获得性肺炎（CAP）病因不明。为提高致病微生物病原体的检出率，对Binax NOW肺炎链球菌尿抗原检测（UAT）进行了评估。
在这项前瞻性研究中，将67例CAP成年患者与81例健康患者进行比较，以确定UAT的敏感性和特异性及其在改善CAP病因诊断中的作用。
采用传统方法可找到22例患者（33%）的病因（14例肺炎链球菌，敏感性64.3%，81份UAT对照尿样中有1份呈阳性，特异性98.8%）。加上尿抗原检测后，这一比例增至33例患者（49%）（p = 0.039）。在我们未通过传统方法进行病因鉴定的患者中，24%通过UAT诊断为肺炎球菌感染。
鉴于其出色的特异性，该检测可被视为检测病因不明的CAP中肺炎链球菌的重要工具，能在四分之一的病例中诊断出肺炎球菌肺炎。
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