What is the role of pneumococcal urinary antigen testing in the evaluation of community-acquired pneumonia (CAP)?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

Pneumococcal urinary antigen testing (UAT) is a non–culture-based test for diagnosing pneumococcal infection that has a reported sensitivity of 50%-80% and specificity of more than 90%. [57] Thus, a negative result does not rule out pneumococcal pneumonia. The UAT results remain positive after antibiotics have been started so may be particularly useful when cultures were not obtained prior to initiation of antibiotic therapy. Recent IDSA guidelines recommend use of pneumococcal urinary antigen testing in adults with severe CAP. [7]

In 2018, Wunderink et al reported that serotype-specific urinary antigen detection assays may further improve detection of pneumococcal pneumonia in hospitalized adults with CAP. [58] Availability of pneumococcal UAT is the main perceived barrier to its routine use. [57]


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