Utility of a Sputum Antigen Detection Test in Pneumococcal Pneumonia and Lower Respiratory Infectious Disease in Adults

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    • Fukushima Kiyoyasu
    • Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Japan
    • Kakugawa Tomoyuki
    • Department of Internal Medicine, Kitakyushu Municipal Yahata Hospital, Japan
    • Izumikawa Koichi
    • The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
    • Aoki Nobuki
    • Department of Internal Medicine, Shinrakuen Hospital, Japan
    • Nishioka Yasuhiko
    • Department of Internal Medicine and Molecular Therapeutics, Institute of Health Biosciences, The University of Tokushima Graduate School, Japan
    • Kosaka Osamu
    • Diagnostic Division, Otsuka Pharmaceutical Co., Ltd., Japan
    • Kohno Shigeru
    • The Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
    • Inoue Yuichi
    • Department of Respiratory Medicine, Isahaya Health Insurance General Hospital, Japan
    • Ishida Tadashi
    • Department of Respiratory Medicine, Kurashiki Central Hospital, Japan
    • Yoshimura Kunihiko
    • Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Japan
    • Sawai Toyomitsu
    • Department of Internal Medicine, Sasebo City General Hospital, Japan
    • Takayanagi Noboru
    • Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan


<b>Objective</b> To compare the utility of Gram staining, a urinary antigen detection kit and a sputum antigen detection kit were examined for the rapid and early detection of pneumococcal pneumonia and lower respiratory infectious diseases.<br> <b>Methods</b> A newly developed sputum pneumococcal antigen detection kit (RAPIRUN), Gram staining, and urinary antigen detection kit (BinaxNOW) were comparatively evaluated for their ability to detect <i>Streptococcus pneumoniae</i> in patients with pneumonia or lower respiratory tract infection. Sputum culture results were used as a standard for comparison. Furthermore, the pneumococcus-positive rates in culture and rapid tests were compared using polymerase chain reaction (PCR) as a reference.<br> <b>Results</b> Of the 169 patients studied, 54 (32.0%) tested positive for <i>S. pneumoniae</i> in culture. <i>S. pneumoniae</i> detection sensitivities for Gram staining, RAPIRUN, and BinaxNOW were 75.9%, 90.7%, and 53.7%, respectively; thus, RAPIRUN had a significantly higher sensitivity than BinaxNOW (p<0.001). For patients with ≥10<sup>5</sup> copies/μg of pneumococcal surface protein A DNA PCR analysis, the detection rates of culture, Gram staining, and RAPIRUN were 85.2%, 72.1%, and 82.0%, respectively, however, the detection rate of BinaxNOW was only 47.5%. Comparisons among 45 patients with culture-positive pneumococcal pneumonia revealed that RAPIRUN had a significantly higher detection rate than BinaxNOW in the mild cases (p<0.006), regardless of the number of days from onset (p<0.03).<br> <b>Conclusion</b> RAPIRUN is a rapid testing kit that detects <i>S. pneumoniae</i> in sputum with a high sensitivity and specificity. It is a particularly more useful detection kit than BinaxNOW for early and mild community-acquired pneumonia in pre-treatment patients whose sputum specimens can be obtained.<br>


  • Internal Medicine

    Internal Medicine 54(22), 2843-2850, 2015

    The Japanese Society of Internal Medicine


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