Abstract
To evaluate the diagnostic accuracy and clinical utility of a serotype specific urinary antigen detection (UAD) multiplex assay for identification of 13 pneumococcal serotypes (1,3,4,5,6A,6B,7F,9V,14,18C,19A,19F,23F) in urine of patients with community acquired pneumonia (CAP).
Adult patients with clinical suspicion of CAP were included. In addition to standard diagnostic procedures, a urine sample was collected to perform the UAD test. Demographic, clinical, radiological and microbiological data were collected.
Among 1,095 CAP patients S. pneumoniae was identified as causative pathogen in 257 (23%), when using conventional diagnostic methods and in 357 (32.6%) when UAD was added. Of the 49 bacteraemic episodes caused by 1 of the 13 serotypes covered by the UAD, 48 were detected by the UAD indicating a sensitivity of 98%. Of the 77 CAP episodes with a “non-UAD” causative pathogen none had a positive UAD result, indicating a specificity of 100%.
Addition of the UAD test to conventional diagnostic methods increased the prevalence of S. pneumoniae CAP by 39%. Using bacteraemic episodes as reference sensitivity and specificity of the UAD was 98% and 100%, respectively.
- ERS