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Article in Japanese
Usefulness of a sputum antigen detection kit for Streptococcus pneumoniae in the rapid diagnosis of community-acquired pneumonia: Comparison with urinary antigen detection test and sputum Gram stain
Kiyoyasu Fukushimaa Shigeki Nakamurab,j Noboru Takayanagic Yasuhito Higashiyamad Tadashi Ishidae Yuichi Inouef Toyomitsu Sawaib,g Kunihiko Yoshimurah,k Tomoyuki Kakugawai Shigeru Kohnoj
aDepartment of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital
bDepartment of Respiratory Medicine, Ureshino Medical Center
cDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center
dDepartment of Respiratory Medicine, Hokusho Central Hospital
eDepartment of Respiratory Medicine, Kurashiki Central Hospital
fDepartment of Respiratory Medicine, Isahaya Health Insurance General Hospital
gDepartment of Internal Medicine, Sasebo City General Hospital
hDepartment of Respiratory Medicine, Respiratory Center, Toranomon Hospital
iDepartment of Internal Medicine, Kitakyushu Municipal Yahata Hospital
jSecond Department of Internal Medicine, Nagasaki University School of Medicine
kDepartment of Respiratory Medicine, Japanese Red Cross Omori Red Cross Hospital
We evaluated the usefulness of a sputum antigen detection kit for Streptococcus pneumoniae in a rapid diagnosis in 166 adult patients (113 males and 53 females) with community-acquired pneumonia who simultaneously underwent all 4 tests of sputum Gram stain, sputum culture, urinary antigen detection test, and sputum antigen detection test in 14 sites in Japan. A total of 53 patients (31.9%) were sputum culture-positive for S. pneumoniae. Based on the sputum culture results, the sensitivity for detecting S. pneumoniae was 73.6% in sputum Gram stain, 62.3% in urinary antigen detection test, and 88.7% in sputum antigen detection test. The sensitivity in the sputum antigen detection test was significantly higher than that in the urinary antigen detection test in patients with mild infection (p<0.03) and in patients whose symptoms started within 2 days before the tests (p<0.03). Sputum antigen detection tests showed a significantly higher concordance rate than the sputum Gram stain tests (p<0.01). These results suggest that the sputum antigen detection kit is useful in the rapid diagnosis of community-acquired pneumococcal pneumonia in adults.
Community acquired pneumonia Streptococcus pneumoniae Rapid diagnosis Sputum Urine
Received 26 Nov 2012 / Accepted 27 Dec 2012
AJRS, 2(4): 343-348, 2013