Positive urinary antigen tests for Streptococcus pneumoniae in community-acquired pneumonia: a 7-year retrospective evaluation of health care cost and treatment consequences

ABSTRACTObjectiveThe etiology and epidemiology of co-infection and secondary infection in COVID-19 patients remain unknown. The study aims to investigate the occurrence and characteristics of co-infection and secondary infection in COVID-19 patients, mainly focusing on Streptococcus pneumoniae co-infections.MethodsThis study was a prospective, observational cohort study of the inpatients diagnosed with COVID-19 in two designated hospitals in south China enrolled between Jan 11 and Feb 22, 2020. The urine specimen was collected on admission and applied for pneumococcal urinary antigen tests (PUATs). Demographic, clinical and microbiological data of patients were recorded simultaneously.ResultA total of 146 patients with a confirm diagnosis of COVID-19 at the median age of 50.0 years (IQR 36.0-61.0) were enrolled, in which, 16 (11.0%) were classified as severe cases and 130 (89.0%) as non-severe cases. Of the enrolled patients, only 3 (2.1%) were considered to present the co-infection, in which 1 was co-infected with S.pneumoniae, 1 with B. Ovatus infection and the other one with Influenza A virus infection. Secondary infection occurred in 16 patients, with S. maltophilia as the most commonly isolated pathogen (43.8%), followed by P. aeruginosa (25.0%), E. aerogenes (25.0%), C. parapsilosis (25.0%) and A. fumigates (18.8%).ConclusionPatients with confirmed COVID-19 were rarely co-infected with Streptococcus pneumoniae or other pathogens, indicating that the application of antibiotics against CAP on admission may not be necessary in the treatment of COVID-19 cases.

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Evaluating the utility of Binax NOW Streptococcus pneumoniae urinary antigen test in adults with community acquired pneumonia in China

The Clinical Respiratory Journal ◽

10.1111/crj.12533 ◽

2016 ◽

Vol 12 (2) ◽

pp. 425-432 ◽

Cited By ~ 2

Author(s):

Fei Zhou ◽

Li Gu ◽

Jiu Xin Qu ◽

Ying Mei Liu ◽

Bin Cao ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

Community Acquired Pneumonia ◽

Antigen Test ◽

Urinary Antigen ◽

Urinary Antigen Test

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

ISRN Infectious Diseases ◽

10.5402/2013/518205 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Lauren K. Troy ◽

Keith K. H. Wong ◽

David J. Barnes

Keyword(s):

Clinical Utility ◽

Length Of Hospital Stay ◽

Community Acquired Pneumonia ◽

Urinary Antigen ◽

Single Centre ◽

Cross Sectional ◽

Single Centre Study ◽

Antigen Tests ◽

Positive Results ◽

Care Support

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=0.01), and a greater likelihood of requiring intensive care support (P=0.006). 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.

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