Urine antigen test highly sensitive for diagnosing Streptococcal pneumonia: BMJ

A conclusive diagnosis of Streptococcus pneumoniae infection in individuals with pneumonia can be made using the urine antigen test (UAT), says an article published in the British Medical Journal.

Urinary antigen assays have been utilized to quickly detect S. pneumoniae infection in pneumonia patients, enabling the administration of tailored medication earlier than with traditional diagnostic culture procedures. Based on a systematic review and meta-analysis, this study was carried out by Shunsuke Yasuo and colleagues to update information on the diagnostic efficacy of urine antigen testing for S. pneumoniae among patients with acute respiratory failure indicative of pneumonia.

For articles published up to June 3, 2020, a thorough search was conducted using MEDLINE and the Cochrane Central Register of Controlled Trials. Selected and analyzed were prospective and retrospective cohort studies (in English) comparing urine antigen testing to culture or smear diagnostic procedures in adult patients with clinically confirmed pneumonia. In order to determine the degree of bias, the QUADAS-2 tool was employed, and a bivariate random effects model was used to conduct a meta-analysis of the chosen papers.

The key findings of this study were as follows:

1. 30 papers out of a total of 2179 that were examined were eligible for quality evaluation and meta-analysis.

2. The research included data from 12 366 individuals overall, including 1548 patients (12.5%) with the target disease and probable pneumococcal pneumonia.

3. The included studies' general caliber was found to be serious. Pooled sensitivity and specificity were determined to be 0.66 (95% CI 0.62 to 0.69) and 0.90 (95% CI 0.85 to 0.93), respectively.

In conclusion, the findings of this study supported other research' findings that UATs have a high specificity and a medium sensitivity. UATs can therefore be helpful for quickly arriving at a conclusive diagnosis in individuals who are suspected of having pneumonia.

Reference: 

Yasuo, S., Murata, M., Nakagawa, N., Kawasaki, T., Yoshida, T., Ando, K., Okamori, S., & Okada, Y. (2022). Diagnostic accuracy of urinary antigen tests for pneumococcal pneumonia among patients with acute respiratory failure suspected pneumonia: a systematic review and meta-analysis. In BMJ Open (Vol. 12, Issue 8, p. e057216). BMJ. https://doi.org/10.1136/bmjopen-2021-057216