Table of Contents
ISRN Infectious Diseases
Volume 2013 (2013), Article ID 518205, 5 pages
http://dx.doi.org/10.5402/2013/518205
Clinical Study

Prevalence and Utility of Positive Pneumococcal Urinary Antigen Tests in Australian Patients with Community-Acquired Pneumonia

1Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Missenden Road Camperdown, Sydney, NSW 2043, Australia
2Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
3Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia

Received 10 July 2012; Accepted 9 August 2012

Academic Editors: F. Su, N. Uchide, and P. Viale

Copyright © 2013 Lauren K. Troy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives. The pneumococcal urinary antigen test (UAT) has superior sensitivity to other investigations in determining the aetiology of community-acquired pneumonia (CAP), but data specific to Australian populations is limited. This study aimed to establish the prevalence and clinical utility of positive UAT in patients admitted to hospital with CAP, as well as associations with positive testing. Methods. A prospective, cross-sectional, single-centre study was performed. Urine antigen tests were performed on all adult patients admitted to hospital with the diagnosis of CAP. Sputum and blood culture results, CURB-65 score of severity, current and prior antibiotics, comorbidities, mortality, and length of hospital stay were recorded. Results. There was a positive test prevalence of 13/170 [7.6% (95% confidence intervals 4.3–13%)]. The overall prevalence of pneumococcal pneumonia was 19/170 (11%), including 8 patients confirmed on positive UAT alone. Patients with a positive UAT result had a higher mean CURB-65 score compared with those with a negative result ( 𝑃 = 0 . 0 1 ), and a greater likelihood of requiring intensive care support ( 𝑃 = 0 . 0 0 6 ). Conclusions. The prevalence of positive UAT was low. Positive results were more often recorded in those with greater severity pneumonia. The clinical utility of the test in this cohort of patients was low.