a Department of Medicine, Health Sciences Division , Universidad del Norte and Hospital Universidad del Norte , Barranquilla , Colombia.
b Department of Microbiology , Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), University of Barcelona , Barcelona , Spain.
Expert Rev Anti Infect Ther. 2019 Feb;17(2):107-115. doi: 10.1080/14787210.2019.1565994. Epub 2019 Jan 9.
Community-acquired pneumonia (CAP) continues to be a leading cause of hospitalization and mortality worldwide. Streptococcus pneumoniae and Legionella pneumophila remain the major etiological agents and are responsible for a significant proportion of CAP mortality. Among diagnostic tests for CAP, urine antigen detection of S. pneumoniae and L. pneumophila is widely accepted due to the simplicity of collection and the rapidity of the test results. Areas covered: This comprehensive review outlines the urinary antigen tests available, discusses their sensitivity and specificity, and assesses the usefulness of their results as the basis for targeted therapy. Expert commentary: There have been advances in urine antigen detection tests for patients with CAP. New methodologies show greater sensitivity, detect S. pneumoniae and L. pneumophila in a single test, and also detect pneumococcal serotypes. In addition, urine antigen detection tests have shown a high specificity, which means that a positive result practically indicates the causative pathogen of CAP. Therefore, a positive result can lead to a targeted therapy that is likely to improve patient outcomes and reduce the risk of resistance and adverse events. However, well-designed studies are needed to evaluate the usefulness of urine antigen detection tests with regard to clinical outcomes.
社区获得性肺炎（CAP）仍然是全球导致住院和死亡的主要原因。肺炎链球菌和嗜肺军团菌仍然是主要的病原体，也是 CAP 死亡率的重要原因。在 CAP 的诊断检测中，由于采集简便和检测结果快速，尿抗原检测肺炎链球菌和嗜肺军团菌已被广泛接受。
这篇全面的综述概述了现有的尿抗原检测试验，讨论了它们的敏感性和特异性，并评估了其结果作为靶向治疗基础的有用性。
针对 CAP 患者的尿抗原检测试验已经取得了进展。新方法学显示出更高的敏感性，可在单次检测中检测肺炎链球菌和嗜肺军团菌，并且还可以检测肺炎球菌血清型。此外，尿抗原检测试验具有很高的特异性，这意味着阳性结果实际上表明 CAP 的致病病原体。因此，阳性结果可能导致靶向治疗，这可能改善患者的结局并降低耐药性和不良事件的风险。然而，需要进行精心设计的研究来评估尿抗原检测试验在临床结局方面的有用性。
