The Urinary Antigen Tests have High Sensitivity in Diagnosis of Pneumococcus Caused Community-Acquired Pneumonia Posterior to Antimicrobial Therapy

2014 ◽  
Vol 70 (2) ◽  
pp. 1029-1034 ◽  
Author(s):  
Ming Chen ◽  
Ming Zhou ◽  
Wei Xiao ◽  
Biao Ai ◽  
Xuezheng Liu ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
High Sensitivity ◽  
Community Acquired Pneumonia ◽  
Urinary Antigen ◽  
Antigen Tests

Urinary antigen tests and the investigation of suspected community acquired pneumonia

2019 ◽  
Vol 79 (4) ◽  
pp. 389-399
Author(s):  
Sakib Rokadiya ◽  
Poppy Denniston ◽  
William Ricketts ◽  
Jonathan Lambourne
Keyword(s):  
Community Acquired Pneumonia ◽  
Urinary Antigen ◽  
Antigen Tests

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

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.

scholarly journals Comparison of Two Urinary Antigen Tests for Establishment of Pneumococcal Etiology of Adult Community-Acquired Pneumonia

2004 ◽  
Vol 42 (8) ◽  
pp. 3620-3625 ◽  
Author(s):  
K. Stralin ◽  
M. S. Kaltoft ◽  
H. B. Konradsen ◽  
P. Olcen ◽  
H. Holmberg
Keyword(s):  
Community Acquired Pneumonia ◽  
Urinary Antigen ◽  
Antigen Tests

scholarly journals Pneumococcal and Legionella Urinary Antigen Tests in Community-acquired Pneumonia: Prospective Evaluation of Indications for Testing

2018 ◽  
Vol 68 (12) ◽  
pp. 2026-2033 ◽  
Author(s):  
Shawna Bellew ◽  
Carlos G Grijalva ◽  
Derek J Williams ◽  
Evan J Anderson ◽  
Richard G Wunderink ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Legionella Pneumophila ◽  
Community Acquired Pneumonia ◽  
Urinary Antigen ◽  
Prospective Surveillance ◽  
Expert Opinions ◽  
Urinary Antigen Testing ◽  
Antigen Tests ◽  
Individual Criterion ◽  
Antigen Testing

Abstract Background Adult, 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. Methods We 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. Results Among 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. Conclusions Recommended 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.

Current Issues of Empirical Therapy of Severe Bacterial Community-Acquired Pneumonia During the Season of Respiratory Viral Infections

2020 ◽  
Vol 65 (9-10) ◽  
pp. 64-70
Author(s):  
V. B. Beloborodov ◽  
I. A. Kovalev ◽  
G. V. Sapronov
Keyword(s):  
Antimicrobial Therapy ◽  
Influenza A ◽  
Bacterial Infections ◽  
Randomized Clinical Trials ◽  
Respiratory Infections ◽  
Molecular Genetic ◽  
Seasonal Fluctuation ◽  
Empirical Therapy ◽  
Community Acquired Pneumonia ◽  
Adverse Event Rate

Progredient growth of morbidity and mortality of patients with community-acquired pneumonia (CAP) requires optimization of treatment including antibacterial therapy. Implementation of molecular-genetic methods of diagnostics of viral and viral-bacterial infections in clinical practice has significantly augmented the conception of etiology of community-acquired pneumonia. Seasonal fluctuation of CAP prevalence corresponds with growth of morbidity of acute respiratory infections and influenza which contribute to the etiological structure of CAP by increasing the risk of infection caused by staphylococci. The synergy between influenza A virus and S.aureus has been shown; it is associated with an increase of virus replication in the presence of specific staphylococcal proteases and the ability of viruses to increase adhesion of S.aureusin the respiratory tract, to decrease phagocytosis of S.aureus by macrophages/neutrophils and production of antimicrobial peptides, as well as to increase the probability of secondary bacterial co-infection. Therefore, the most important requirement for the empiric therapy agents of CAP is high streptococcal and staphylococcal activity. According to the current guidelines on antimicrobial therapy of severe CAP, antipneumococcic cephalosporins, macrolides, and fluoroquinolones are the basic treatment agents, but none of them have the combined high antistaphylococcal and antipneumococcal activity inherent in ceftaroline. The advantages of ceftaroline over ceftriaxone and levofloxacin in terms of the probability of reaching target concentrations for clinically relevant pharmacokinetic/pharmacodynamic parameters are shown. Meta-analysis of randomized clinical trials showed the higher clinical efficacy of ceftaroline in comparison to ceftriaxone with similar adverse event rate. Summarized analysis of antibiotic susceptibility data, pharmacokinetic/pharmacodynamic and clinical data, as well as negative epidemiological trends confirms the necessity of optimization of antimicrobial therapy of CAP for implementation of ceftaroline advantages against pneumococci and staphylococci in comparison to other β-lactams. Therefore, empiric treatment with ceftaroline is the most rational option for the therapy of CAP in critically ill patients during the season of respiratory viral infection.

Community acquired pneumonia-current scenario among immunocompromised patients in a tertiary care hospital

2016 ◽  
Vol 5 (01) ◽  
pp. 4715
Author(s):  
A. V. Sowmya* ◽  
G. Jayalakshmi ◽  
David Agatha
Keyword(s):  
Diabetes Mellitus ◽  
Antimicrobial Therapy ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Polymicrobial Infection ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Immunocompromised Patients ◽  
Drug Resistant ◽  
Etiologic Agents

Pneumonia is a common illness accounting for majority of hospitalizations worldwide with significant mortality and morbidity. Antimicrobial therapy, being the main stay of treatment, the choices of antibiotics depends on the nature of the etiologic agents and the host factors. The current study was aimed to identify the bacterial & fungal etiologic agents of Community Acquired Pneumonia (CAP) in Immunocompromised (IC) patients, with their antimicrobial resistant pattern and to analyze the associated immunocompromised states. Various respiratory samples from study group of 75 immunocompromised patients with features of pneumonia were collected, processed and the isolates were identified with their antimicrobial susceptibility& resistance pattern according to CLSI guidelines. The results were analyzed statistically. Diabetes mellitus is the most common immunocompromised state (48%) associated with CAP. Monomicrobial and polymicrobial infection rates were 80.36% and 19.64% respectively. Gram negative pathogens and fungal pathogens were identified in 60% and 25.37% of culture positive cases respectively. Diabetes mellitus is commonly found in association with polymicrobial infection (19.44%) and fungal infection (16.66%). Drug resistant strains comprise about 75% of MRSA strains, 72.72 % of ESBL producers and 3.44% of Amp C producers. As the number of elderly people with associated IC state is on rise, with change in the pattern of microbial etiologic agents causing CAP, a prior knowledge of the host and microbial factors will help in formulating empirical antimicrobial therapy and proper treatment thereby curbing the spread of infections by drug resistant pathogens and the associated morbidity and mortality.

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