ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Pneumococcal and Legionella Urinary Antigen Tests in Community-acquired Pneumonia: Prospective Evaluation of Indications for Testing.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 52 citations in OpenAlex.
- Legionella pneumophila pneumonia in South Eastern Sydney: diagnosis, prognosis and public health outcomes.Internal medicine journal · 2026Article
- Legionella Pneumonia Associated With Rhabdomyolysis and Acute Renal Failure: A Case Report.Cureus · 2026Article
- No culture? No problem: Clinical utility and pitfalls of non-culture diagnostics for pneumococcal parapneumonic effusions.Frontiers in medicine · 2026Review
- My approach to respiratory sepsis: pulmonary.Breathe (Sheffield, England) · 2026Review
- Community-AcquiredPathogens (Basel, Switzerland) · 2025Article
- Beyond Microbiological Analysis: The Essential Role of Risk Assessment in Travel-Associated Legionnaires' Disease Outbreak Investigations.Pathogens (Basel, Switzerland) · 2025Article
- Test and treat-impact of microbiological testing on antibiotic prescribing for Legionnaires' disease in Switzerland: results of the multicentre SwissLEGIO study.Pneumonia (Nathan Qld.) · 2025Article
- Diagnosis of acute Q fever using targeted next‑generation sequencing: A case report.Experimental and therapeutic medicine · 2025Article
- A Review on Risk Factors, Traditional Diagnostic Techniques, and Biomarkers for Pneumonia Prognostication and Management in Diabetic Patients.Diseases (Basel, Switzerland) · 2024Review
- Prevalence, Clinical Severity, and Serotype Distribution of Pneumococcal Pneumonia Among Adults Hospitalized With Community-Acquired Pneumonia in Tennessee and Georgia, 2018-2022.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- Practicing Medicine Wisely: Routine Use of Urine Legionella in Suspicious Pneumonia - Are we Overdoing?JNMA; journal of the Nepal Medical Association · 2024Article
- Severe Legionnaires' disease.Annals of intensive care · 2024Review
- Things We Do for No Reason - OrderingOpen forum infectious diseases · 2024Article
- Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review.Journal of clinical medicine · 2023Review
- Article
- Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort.Journal of clinical medicine · 2023Article
- Derivation and external validation of a prediction model for pneumococcal urinary antigen test positivity in patients with community-acquired pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Clinical microbiology in detection and identification of emerging microbial pathogens: past, present and future.Emerging microbes & infections · 2022Article
- A risk model to identify Legionella among patients admitted with community-acquired pneumonia: A retrospective cohort study.Journal of hospital medicine · 2022Article
Corrections and comments
- Commented on by
Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundAdult, community-acquired pneumonia (CAP) guidelines from the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) include indications for urinary antigen tests (UATs) for Streptococcus pneumoniae (SP) and Legionella pneumophila (LP). These recommendations were based on expert opinions and have not been rigorously evaluated.
methodsWe used data from a multicenter, prospective, surveillance study of adults hospitalized with CAP to evaluate the sensitivity and specificity of the IDSA/ATS UAT indications for identifying patients who test positive. SP and LP UATs were completed on all included patients. Separate analyses were completed for SP and LP, using 2-by-2 contingency tables, comparing the IDSA/ATS indications (UAT recommended vs not recommended) and UAT results (positive vs negative). Additionally, logistic regression was used to evaluate the association of each individual criterion in the IDSA/ATS indications with positive UAT results.
resultsAmong 1941 patients, UATs were positive for SP in 81 (4.2%) and for LP in 32 (1.6%). IDSA/ATS indications had 61% sensitivity (95% confidence interval [CI] 49-71%) and 39% specificity (95% CI 37-41%) for SP, and 63% sensitivity (95% CI 44-79%) and 35% specificity (95% CI 33-37%) for LP. No clinical characteristics were strongly associated with positive SP UATs, while features associated with positive LP UATs were hyponatremia, fever, diarrhea, and recent travel.
conclusionsRecommended indications for SP and LP urinary antigen testing in the IDSA/ATS CAP guidelines have poor sensitivity and specificity for identifying patients with positive tests; future CAP guidelines should consider other strategies for determining which patients should undergo urinary antigen testing.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.