Department of Pediatrics, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
J Formos Med Assoc. 2011 Oct;110(10):613-8. doi: 10.1016/j.jfma.2011.08.002. Epub 2011 Sep 15.
BACKGROUND/PURPOSE: Streptococcus pneumoniae is the most common bacterial cause of community-acquired pneumonia in children. This study was designed to determine whether a newly designed urinary antigen test score correlated with severity of pneumococcal pneumonia in children.
We recruited 119 children hospitalized with pneumonia diagnosed by positive urinary pneumococcal antigen test at the National Cheng Kung University Hospital from 2002 through 2007. The urinary antigen reactivity score was determined by the rate of the reaction time and intensity of the pneumococcal antigen-antibody band. The children were stratified into three groups according to total score: group I, 8; group II, 5-7; and group III, 2-4. Disease severity was based on clinical presentation and radiological and laboratory findings.
Patients in group I had significantly more respiratory distress (p = 0.01), oxygen desaturation (p = 0.04), febrile days (p = 0.03), pulmonary complications (p = 0.01), and bacteremia (p = 0.01), greater requirement for intensive care (p = 0.004), longer hospital stays (p < 0.001), and lower white blood cell counts (p = 0.01) than patients in group II or III.
A new urinary pneumococcal antigen test score correlated well with the severity of pneumococcal pneumonia in children. It might provide helpful diagnostic and prognostic information.
背景/目的：肺炎链球菌是儿童社区获得性肺炎最常见的细菌病因。本研究旨在确定新设计的尿抗原检测评分是否与儿童肺炎链球菌肺炎的严重程度相关。
我们招募了 2002 年至 2007 年期间在国立成功大学医院因阳性尿肺炎球菌抗原检测而住院的 119 名肺炎患儿。尿抗原反应性评分通过反应时间和肺炎球菌抗原-抗体带的强度的比率来确定。根据总评分将儿童分为三组：组 I，8 分；组 II，5-7 分；组 III，2-4 分。疾病严重程度基于临床表现、影像学和实验室发现。
组 I 的患者呼吸窘迫（p=0.01）、氧饱和度下降（p=0.04）、发热天数（p=0.03）、肺部并发症（p=0.01）和菌血症（p=0.01）的发生率显著更高，需要更加强化护理（p=0.004）、住院时间更长（p<0.001）和白细胞计数更低（p=0.01），与组 II 或 III 的患者相比。
一种新的尿肺炎球菌抗原检测评分与儿童肺炎链球菌肺炎的严重程度密切相关。它可能提供有帮助的诊断和预后信息。
