ArticleJournal of clinical microbiology2009
Diagnosis of Streptococcus pneumoniae infections in adults with bacteremia and community-acquired pneumonia: clinical comparison of pneumococcal PCR and urinary antigen detection.
Article in Journal of clinical microbiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Systematic review and meta-analysis of a urine-based pneumococcal antigen test for diagnosis of community-acquired pneumonia caused by Streptococcus pneumoniae.Journal of clinical microbiology · 2013Pooled it
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- PCR using blood for diagnosis of invasive pneumococcal disease: systematic review and meta-analysis.Journal of clinical microbiology · 2010Pooled it
- Micro/nanotechnology-inspired rapid diagnosis of respiratory infectious diseases.Biomedical engineering letters · 2021Review
- Article
- Methodological criticisms in the evaluation of Pneumococcal Conjugate Vaccine effectiveness.Journal of preventive medicine and hygiene · 2015Review
- Respiratory Infections in the U.S. Military: Recent Experience and Control.Clinical microbiology reviews · 2015Review
- Detection and serotyping of pneumococci in community acquired pneumonia patients without culture using blood and urine samples.BMC infectious diseases · 2015Article
- Clinical factors associated with negative urinary antigen tests implemented for the diagnosis of community-acquired pneumococcal pneumonia in adult patients.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2015Article
- [Which samples to obtain in the emergency department for the microbiological diagnosis of community-acquired pneumonia in the immunocompetent patient?]Reanimation : journal de la Societe de reanimation de langue francaise · 2014Article
- Pneumococcal urinary antigen positivity in healthy colonized children: is it age dependent?Wiener klinische Wochenschrift · 2013Article
- Can an etiologic agent be identified in adults who are hospitalized for community-acquired pneumonia: results of a one-year study.The Journal of infection · 2013Article
- What is the role of newer molecular tests in the management of CAP?Infectious disease clinics of North America · 2013Review
- Validation of an immunodiagnostic assay for detection of 13 Streptococcus pneumoniae serotype-specific polysaccharides in human urine.Clinical and vaccine immunology : CVI · 2012Article
- Microbial diagnostics in patients with presumed severe infection in the emergency department.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2012Article
- Article
- New diagnostic tests for pneumonia: what is their role in clinical practice?Clinics in chest medicine · 2011Review
- Elderly patients with community-acquired pneumonia: optimal treatment strategies.Drugs & aging · 2011Review
- Pneumococcal DNA is not detectable in the blood of healthy carrier children by real-time PCR targeting the lytA gene.Journal of medical microbiology · 2011Article
- Interpreting assays for the detection of Streptococcus pneumoniae.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2011Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The diagnosis of severe Streptococcus pneumoniae infection relies heavily on insensitive culture techniques. To improve the usefulness of PCR assays, we developed a dual-PCR protocol (targeted at pneumolysin and autolysin) for EDTA blood samples. This was compared to the Binax NOW S. pneumoniae urine antigen test in patients with bacteremic pneumococcal infections. Patients with nonbacteremic community-acquired pneumonia also were tested by these methods to determine what proportion could be confirmed as pneumococcal infections. A direct comparison was made in a group of patients who each had both tests performed. The Binax NOW S. pneumoniae urine antigen test was positive in 51 of 58 bacteremic pneumococcal cases (sensitivity, 88%; 95% confidence interval [CI], 77 to 95%), whereas the dual PCR was positive in 31 cases (sensitivity, 53.5%; 95% CI, 40 to 67%; P < 0.0001), and all of these had detectable urinary antigens. Both tests gave positive results in 2 of 51 control patients (referred to as other-organism septicemia), giving a specificity of 96% (95% CI, 86.5 to 99.5%). In 77 patients with nonbacteremic community-acquired pneumonia, urinary antigen was detected significantly more often (in 21 patients [27%]) than a positive result by the dual-PCR protocol (6 [8%]) (P = 0.002). The development of a dual-PCR protocol enhanced the sensitivity compared to that of the individual assays, but it is still significantly less sensitive than the Binax NOW urine antigen test, as well as being more time-consuming and expensive. Urinary antigen detection is the nonculture diagnostic method of choice for patients with possible severe pneumococcal infection.
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Registered trials
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