Evaluation of the Binax NOW Streptococcus pneumoniae urinary antigen assay in intensive care patients hospitalized for pneumonia
Evaluation of the Binax NOW Streptococcus pneumoniae urinary antigen assay in intensive care patients hospitalized for pneumonia
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DOI：
10.1007/s00134-006-0329-9
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发表时间：
2006-11-01
影响因子：
38.9
通讯作者：
Sollet, Jean-Pierre
中科院分区：
文献类型：
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作者：
Lasocki, Sigismond;Scanvic, Agnes;Sollet, Jean-Pierre
目的：评价Binax Now S的诊断性能。肺炎尿抗原快速免疫层析膜试验（ICT）的疑似社区获得性肺炎住院重症监护患者，并评估其诊断性能的影响，以前的抗生素。设计和背景：在一家拥有700张床位的综合医院的内科外科ICU中进行回顾性研究。患者：审查了2002年5月至2004年7月期间进行ICT的患者图表（结果设盲）。在该单位住院的1 006名患者中，有140人接受了信通技术治疗;三分之二的患者在入院前接受了抗生素治疗。测量和结果：肺炎的诊断是根据通常的标准。所有患者至少进行了一次微生物检查。肺炎确诊108例，其中肺炎球菌32例。ICT在32例肺炎球菌性肺炎患者中有23例阳性，在108例非肺炎患者中有11例阳性，在32例非肺炎患者中无一例阳性，其敏感性、特异性、阳性和阴性预测值分别为：72%、90%、68%和92%。在既往使用或未使用抗生素的患者中，阳性似然比相当（总体人群中分别为6和12/7）。结论：这是对因疑似社区获得性肺炎而住院的重症监护患者进行的首次ICT临床评估，即使在既往使用抗生素的情况下，其性能也与已发表的数据一致。其临床意义和对抗生素政策的影响仍有待完善。
Objective: To evaluate the diagnostic performance of Binax Now S. pneumoniae urinary antigen rapid immunochromatographic membrane test (ICT) for patients with suspicion of community-acquired pneumonia hospitalized in intensive care and to assess the impact of prior antibiotics on its diagnostic performance. Design and setting: Retrospective study in a medicosurgical ICU in a 700-bed general hospital. Patients: Charts of patients with ICT performed (result blinded) were reviewed between May 2002 and July 2004. ICT has been performed in 140 of the 1,006 patients hospitalized in the unit; two-thirds had received antibiotics prior to admission. Measurements and results: Diagnosis of pneumonia was made according to usual criteria. All patients had at least one microbiological test. Pneumonia diagnosis confirmed in 108 patients including 32 pneumococcal. ICT was positive in 23 of 32 patients with pneumococcal pneumonia, in 11 of 108 without, and in none of the 32 patients without pneumonia, resulting in sensitivity, specificity, and positive and negative predictive values of, respectively: 72%, 90%, 68% and 92%. Positive likelihood ratios were comparable among patients with or without prior antibiotics (respectively 6 and 12 for 7 in the overall population). Conclusions: This first clinical evaluation of ICT in intensive care patients hospitalized for suspicion of community-acquired pneumonia, demonstrated performance in accordance with published data even in the case of prior antibiotics. Its clinical interest and impact on antibiotics policy remain to be refined.