This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Smith, M. D. Articles by Cartwright, K. Search for Related Content PubMed PubMed Citation Articles by Smith, M. D. Articles by Cartwright, K.

Rapid Diagnosis of Bacteremic Pneumococcal Infections in Adults by Using the Binax NOW Streptococcus pneumoniae Urinary Antigen Test: a Prospective, Controlled Clinical Evaluation

Public Health Laboratory, Taunton and Somerset Hospital, Taunton, TA1 5DB,¹ Public Health Laboratory, Bristol Royal Infirmary, Bristol, BS2 8HW,² Public Health Laboratory, Gloucestershire Royal Hospital, Gloucester, GL1 3NN,³ Public Health Laboratory, Derriford Hospital, Plymouth, PL6 8DH, United Kingdom⁴

Received 3 January 2003/ Returned for modification 27 February 2003/ Accepted 14 April 2003

The diagnosis of severe pneumococcal infections is inadequate, relying heavily on culture of Streptococcus pneumoniae from blood or other normally sterile fluids, and is severely limited by prior administration of antibiotics. We evaluated prospectively the Binax NOW S. pneumoniae urinary antigen test, a rapid immunochromatographic assay, for the diagnosis of bacteremic pneumococcal infections in hospitalized adult patients. Antigen was detected in 88 of 107 cases overall, resulting in a test sensitivity of 82% (95% confidence interval [95% CI], 74 to 89%). Antigen detection was greater in those with pneumonia (67 of 77 [87%]) than in those without pneumonia (21 of 30 [70%]) (P = 0.04). Urinary antigen was also detected in 3 of 106 adult patients with community-acquired septicemic infections caused by other organisms, giving a test specificity of 97% (95% CI, 92 to 99%). For 45 pneumococcal bacteremia patients with a positive test on treatment day 1, urinary antigen excretion was monitored for the first week of antibiotic treatment. Antigen was still detectable in 83% (29 of 35 tested; 95% CI, 66 to 93%) on treatment day 3. Detection of urinary antigen is a valuable, sensitive, and rapid test for the early diagnosis of bacteremic pneumococcal infections in adult patients, even after antibiotic treatment has commenced.

This article has been cited by other articles:

• Anjay, M A, Anoop, P (2008). DIAGNOSTIC UTILITY OF RAPID IMMUNOCHROMATOGRAPHIC URINE ANTIGEN TESTING IN SUSPECTED PNEUMOCOCCAL INFECTIONS. Arch. Dis. Child. 93: 628-631 [Full Text]  
• del Mar Garcia-Suarez, M., Cima-Cabal, M. D., Villaverde, R., Espinosa, E., Falguera, M., de Los Toyos, J. R., Vazquez, F., Mendez, F. J. (2007). Performance of a Pneumolysin Enzyme-Linked Immunosorbent Assay for Diagnosis of Pneumococcal Infections. J. Clin. Microbiol. 45: 3549-3554 [Abstract] [Full Text]  
• Gisselsson-Solen, M., Bylander, A., Wilhelmsson, C., Hermansson, A., Melhus, A. (2007). The Binax NOW Test as a Tool for Diagnosis of Severe Acute Otitis Media and Associated Complications. J. Clin. Microbiol. 45: 3003-3007 [Abstract] [Full Text]  
• Porcel, J. M., Ruiz-Gonzalez, A., Falguera, M., Nogues, A., Galindo, C., Carratala, J., Esquerda, A. (2007). Contribution of a Pleural Antigen Assay (Binax NOW) to the Diagnosis of Pneumococcal Pneumonia. Chest 131: 1442-1447 [Abstract] [Full Text]  
• Leeming, J. P., Cartwright, K., Morris, R., Martin, S. A., Smith, M. D., on behalf of the South-West Pneumococcus Study Gro, (2005). Diagnosis of Invasive Pneumococcal Infection by Serotype-Specific Urinary Antigen Detection. J. Clin. Microbiol. 43: 4972-4976 [Abstract] [Full Text]  
• Jacobs, J. A., Stobberingh, E. E., Cornelissen, E. I. M., Drent, M. (2005). Detection of Streptococcus pneumoniae Antigen in Bronchoalveolar Lavage Fluid Samples by a Rapid Immunochromatographic Membrane Assay. J. Clin. Microbiol. 43: 4037-4040 [Abstract] [Full Text]  
• Petti, C. A., Woods, C. W., Reller, L. B. (2005). Streptococcus pneumoniae Antigen Test Using Positive Blood Culture Bottles as an Alternative Method To Diagnose Pneumococcal Bacteremia. J. Clin. Microbiol. 43: 2510-2512 [Abstract] [Full Text]  
• Navarro, D., Garcia-Maset, L., Gimeno, C., Escribano, A., Garcia-de-Lomas, J., the Spanish Pneumococcal Infection Study Network, (2004). Performance of the Binax NOW Streptococcus pneumoniae Urinary Antigen Assay for Diagnosis of Pneumonia in Children with Underlying Pulmonary Diseases in the Absence of Acute Pneumococcal Infection. J. Clin. Microbiol. 42: 4853-4855 [Abstract] [Full Text]  
• Stralin, K., Kaltoft, M. S., Konradsen, H. B., Olcen, P., Holmberg, H. (2004). Comparison of Two Urinary Antigen Tests for Establishment of Pneumococcal Etiology of Adult Community-Acquired Pneumonia. J. Clin. Microbiol. 42: 3620-3625 [Abstract] [Full Text]  
• Sheppard, C. L., Harrison, T. G., Morris, R., Hogan, A., George, R. C. (2004). Autolysin-targeted LightCycler assay including internal process control for detection of Streptococcus pneumoniae DNA in clinical samples. J Med Microbiol 53: 189-195 [Abstract] [Full Text]  
• (2003). Diagnostic Utility of Pneumococcal Urinary Antigen Assay. JWatch Infect. Diseases 2003: 1-1 [Full Text]