Khaleel Mohammed, Samreen Sara, Sirangi Saritha, Dinesh Eshwar Mummareddi, R M Padmaja, Dhanekula Kalyani
Microbiology, Mahavir Institute of Medical Sciences, Vikarabad, IND.
General Surgery, Deccan College of Medical Sciences, Hyderabad, IND.
Cureus. 2023 Aug 24;15(8):e44078. doi: 10.7759/cureus.44078. eCollection 2023 Aug.
Introduction Community-acquired pneumonia (CAP) is among the most common public health problems encountered throughout the world. CAP is a frequent cause of lower respiratory tract infections among children and geriatric-age persons. The etiology of CAP is complex but generally involves infection with bacteria like (. ), which is the most common cause of CAP. The underdiagnosis of CAP due to the limitations of conventional culture methods could be responsible for severe morbidity and mortality, especially among susceptible populations. We evaluated the usefulness of a rapid immunochromatographic test (BinaxNOW™, Abbott, Chicago, IL) that detects . through a rapid urine antigen test (RUAT) as a point-of-care (POC) diagnostic method in the early detection of CAP. Methods A prospective study was conducted in a university-affiliated teaching hospital between January 2019 and September 2019 (nine months). The study recruited 300 inpatients who revealed signs and symptoms associated with pneumonia. The study was approved by the institutional ethics committee, and all participants provided their voluntary informed consent. Laboratory evaluation included the collection of sputum samples, which were processed for Gram stain and routine culture. Five milliliters of blood were collected from all the subjects for carrying out a blood culture. A urine sample was collected from each participant for the detection of . through the point-of-care urinary antigen test. Results Of the 300 patients diagnosed with CAP, the . RUAT was positive in 110 out of 140 cases of pneumococcal pneumoniae (78.57%). The RUAT results were positive for 20 (66.6%) out of 30 bacteremic patients and for 90 (81.8%) out of 110 patients positive for sputum culture. The RUAT was positive in 10 out of 20 cases of pneumonia with an unknown microbial etiology. The overall sensitivity (78.57%), specificity (100%), positive predictive value (100%), negative predictive value (98.88%), and accuracy (90%) of the RUAT were similar to sputum culture results. Conclusion The RUAT has shown comparable efficacy with sputum culture and therefore can be used as a complementary approach to conventional methods in the early diagnosis of CAP caused by . Due to its ease of use and rapid results, it could be incorporated as a POC diagnostic test.
引言 社区获得性肺炎（CAP）是全球最常见的公共卫生问题之一。CAP是儿童和老年人下呼吸道感染的常见病因。CAP的病因复杂，但通常涉及感染如（. ）等细菌，这是CAP最常见的病因。由于传统培养方法的局限性导致CAP诊断不足，可能会导致严重的发病率和死亡率，尤其是在易感人群中。我们评估了一种快速免疫层析试验（BinaxNOW™，雅培公司，伊利诺伊州芝加哥）通过快速尿液抗原检测（RUAT）检测（. ）作为即时检测（POC）诊断方法在CAP早期检测中的有用性。
方法 2019年1月至2019年9月（九个月）在一家大学附属医院进行了一项前瞻性研究。该研究招募了300名出现与肺炎相关体征和症状的住院患者。该研究获得了机构伦理委员会的批准，所有参与者均提供了自愿知情同意书。实验室评估包括收集痰液样本，进行革兰氏染色和常规培养。从所有受试者中采集5毫升血液进行血培养。从每个参与者中采集尿液样本，通过即时检测尿液抗原试验检测（. ）。
结果 在300例诊断为CAP的患者中，140例肺炎链球菌肺炎患者中有110例（78.57%）的（. ）RUAT呈阳性。30例菌血症患者中有20例（66.6%）的RUAT结果呈阳性，110例痰培养阳性患者中有90例（81.8%）的RUAT结果呈阳性。20例微生物病因不明的肺炎患者中有10例的RUAT呈阳性。RUAT的总体敏感性（78.57%）、特异性（100%）、阳性预测值（100%）、阴性预测值（98.88%）和准确性（90%）与痰培养结果相似。
结论 RUAT已显示出与痰培养相当的疗效，因此可作为传统方法的补充手段用于由（. ）引起的CAP的早期诊断。由于其使用方便且结果快速，它可作为一种即时检测诊断试验。
