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Journal of Clinical Microbiology, October 2001, p. 3495-3498, Vol. 39, No. 10
Microbiology Unit, Canterbury Health
Laboratories,1 and Christchurch School
of Medicine, University of Otago,3 Christchurch,
and Waikato Hospital, Hamilton,4 New
Zealand, and Clinical Microbiology Laboratory, Duke
University Medical Center, Durham, North Carolina
277102
Received 21 March 2001/Returned for modification 9 July
2001/Accepted 26 July 2001
Streptococcus pneumoniae is the most common cause of
community-acquired pneumonia but is undoubtedly underdiagnosed.
Isolation of S. pneumoniae from blood is specific but
lacks sensitivity, while isolation of S. pneumoniae from
sputum may represent colonization. We evaluated a new
immunochromatographic test (NOW S. pneumoniae urinary
antigen test; Binax, Portland, Maine) that is simple to perform and
that can detect S. pneumoniae antigen in urine within 15 min. Urine samples from 420 adults with community-acquired pneumonia
and 169 control patients who did not have pneumonia were tested. Urine
from 315 (75%) of the pneumonia patients and all controls was tested
both before and after 25-fold concentration, while the remaining 105 samples were only tested without concentration. S.
pneumoniae urinary antigen tests were positive for 120 (29%) patients with pneumonia and for none of the controls. Of the urine samples tested with and without concentration, 96 were positive, of
which 6 were positive only after concentration. S.
pneumoniae antigen was detected in the urine from 16 of the 20 (80%) patients with blood cultures positive for S.
pneumoniae and from 28 of the 54 (52%) patients with
sputum cultures positive for S. pneumoniae. The absence
of S. pneumoniae antigen in the urine from controls suggests that the specificity is high. Concentration of urine prior to
testing resulted in a small increase in yield. The NOW S.
pneumoniae urinary antigen test should be a useful adjunct to
culture for determining the etiology of community-acquired pneumonia in adults.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.10.3495-3498.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Evaluation of a Rapid Immunochromatographic Test
for Detection of Streptococcus pneumoniae Antigen in
Urine Samples from Adults with Community-Acquired
Pneumonia
*
Corresponding author. Mailing address: Microbiology
Unit, Canterbury Health Laboratories, P.O. Box 151, Christchurch, New Zealand. Phone: 64 3 364 1530. Fax: 64 3 364 0238. E-mail:
david.murdoch{at}cdhb.govt.nz.
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