[Relevance of the detection of Streptococcus pneumoniae antigen in human urine in the diagnosis of lower respiratory tract infections]. / Relevancia de la detección del antígeno de Streptococcus pneumoniae en orina en el diagnóstico de las infecciones de las vías respiratorias bajas.

BACKGROUND AND OBJECTIVE: Techniques membrane antigen immunochromatographic detecting in urine the pneumococcal polysaccharide C, have developed significantly, increasing requests for antigenuria to clinical microbiology laboratories. We evaluated the impact of the application of this test in the diagnosis of infections of lower respiratory tract. PATIENTS AND METHOD: Six hundred and sixteen determinations were performed by antigenuria BinaxNOW(®) S. pneumoniae in as many patients over 14 years admitted to the Hospital Universitario Virgen de las Nieves (Granada) between November 2010 and March 2011. RESULTS: In 91.1% of patients who were determined antigenuria the presence of respiratory symptoms justified the request. Only 8.4% of 616 antigenurias performed were positive. S. pneumoniae was isolated from the respiratory sample culture in 8 of these 52 patients. In 29.8% of patients the diagnosis of lower respiratory tract infection was based on clinical, radiological and/or analytical, as antigenurias were negative and did not involve any other additional microbiological test. CONCLUSIONS: We believe that this technique should be used in a complementary manner, and never to the detriment of other microbiological tests, especially in hospitalized patients.

Relevancia de la detección del antígeno de Streptococcus pneumoniae en orina en el diagnóstico de las infecciones de las vías respiratorias bajas / Relevance of the detection of Streptococcus pneumoniae antigen in human urine in the diagnosis of lower respiratory tract infections

Fundamento y objetivo. Las técnicas de inmunocromatografía de membrana que detectan en orina el antígeno polisacárido C de neumococo, han experimentado un auge importante, aumentando las peticiones de antigenuria a los laboratorios de Microbiología Clínica. Se evaluó el impacto de la solicitud de esta prueba en el diagnóstico de las infecciones de las vías respiratorias bajas. Pacientes y método. Se realizaron 616 determinaciones de antigenuria mediante BinaxNOW® S. pneumoniae en otros tantos pacientes mayores de 14 años ingresados en el Hospital Universitario Virgen de las Nieves (Granada) entre noviembre de 2010 y marzo de 2011. Resultados. En el 91,1% de pacientes en los que se determinó la antigenuria, existió sintomatología respiratoria que justificó dicha solicitud. Sólo el 8,4% de las 616 antigenurias realizadas fueron positivas. S. pneumoniae fue aislado en el cultivo de la muestra respiratoria en 8 de estos 52 pacientes. En el 29,8% de los pacientes, el diagnóstico de infección de vías respiratorias bajas se basó en criterios clínicos, radiológicos y/o analíticos, ya que las antigenurias fueron negativas y no se realizó ninguna otra prueba microbiológica adicional. Conclusiones. Consideramos que esta técnica debe emplearse de forma complementaria, y nunca en detrimento de otras pruebas de diagnóstico microbiológico, especialmente en el paciente hospitalizado(AU)

Background and objective. Techniques membrane antigen immunochromatographic detecting in urine the pneumococcal polysaccharide C, have developed significantly, increasing requests for antigenuria to clinical microbiology laboratories. We evaluated the impact of the application of this test in the diagnosis of infections of lower respiratory tract. Patients and method. Six hundred and sixteen determinations were performed by antigenuria BinaxNOW® S. pneumoniae in as many patients over 14 years admitted to the Hospital Universitario Virgen de las Nieves (Granada) between November 2010 and March 2011. Results. In 91.1% of patients who were determined antigenuria the presence of respiratory symptoms justified the request. Only 8.4% of 616 antigenurias performed were positive. S. pneumoniae was isolated from the respiratory sample culture in 8 of these 52 patients. In 29.8% of patients the diagnosis of lower respiratory tract infection was based on clinical, radiological and/or analytical, as antigenurias were negative and did not involve any other additional microbiological test. Conclusions. We believe that this technique should be used in a complementary manner, and never to the detriment of other microbiological tests, especially in hospitalized patients(AU)