Rapid Detection Of Streptococcus Pneumoniae In Community-acquired Pneumonia
adults; antimicrobial therapy; bacteremic pneumococcal pneumonia; cerebrospinal-fluid; diagnosis; infections; Infectious Diseases; management; Microbiology; pneumococcus; pneumonia; polymerase chain-reaction; rapid detection; sputum culture; urinary antigen test
File T M; Kozlov R S
Clinical Microbiology and Infection
2006
2006-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1469-0691.2006.01653.x" target="_blank" rel="noreferrer noopener">10.1111/j.1469-0691.2006.01653.x</a>
Adult bacteremic pneumococcal pneumonia in a community teaching hospital, 1992-1996 - A detailed analysis of 108 cases
acquired pneumonia; antimicrobial resistance; diagnosis; disease; General & Internal Medicine; penicillin-resistant pneumococci; polysaccharide vaccine; risk-factors; sputum culture; Streptococcus pneumoniae; united-states
Objectives: To review the clinical and laboratory findings of 108 adult patients with bacteremic pneumococcal pneumonia admitted to a community hospital and to determine the value of sputum Gram stains and cultures in the diagnosis of pneumococcal pneumonia in this setting. Methods: Using the laboratory logbooks to identify adult inpatients with pneumococcal bacteremia from January 1, 1992, to June 30, 1996, we reviewed medical records. Results: We found 108 patients. There was an apparent increase in prevalence from 1995 to 1996 compared with 1992 to 1994. Patients included 44 men and 64 women. Ages ranged from 20 to 95 years (median, 70 years). The fatality rate was 24.1% and increased with advancing age (no patient younger than 45 years died, and 36.8% of patients aged 85-95 years died). Cigarette smoking, cardiovascular disease, chronic obstructive lung disease, malignant disease, and diabetes mellitus were major underlying conditions. Fever, dyspnea, and cough were the most common presenting symptoms. Sputum Gram stain was useful in the diagnosis when moderate to abundant Gram-positive diplococci were seen. Sputum culture was less useful. Factors associated with higher fatality rate were being 65 years of age or older, APACHE II (Acute Physiologic and Chronic Health Evaluation II) score greater than 15, intensive care unit admission, low or normal leukocyte count, thrombocytopenia, renal dysfunction, diffused infiltrates on chest radiography, bilateral pneumonia, and sputum culture positive for Streptococcus pneumoniae. Conclusions: We found a recent increase in the prevalence of bacteremic pneumococcal pneumonia in adults. Gram stain of sputum is useful, but sputum culture is less sensitive in the diagnosis of pneumococcal pneumonia. The fatality rate remains high. More effort should be made at prevention using pneumococcal immunization.
Watanakunakorn C; Bailey T A
Archives of Internal Medicine
1997
1997-09
Journal Article
<a href="http://doi.org/10.1001/archinte.157.17.1965" target="_blank" rel="noreferrer noopener">10.1001/archinte.157.17.1965</a>
Performance measure of urinary antigen in patients with Streptococcus pneumoniae bacteremia
adults; assay binax; bacteremia; community-acquired pneumonia; diagnosis; etiologic diagnosis; infections; Infectious Diseases; management; Microbiology; pneumococcal pneumonia; rapid diagnosis; severity; sputum culture; Streptococcus pneumoniae; Urinary antigen
The Streptococcus pneumoniae (SP) urinary antigen (UAg) test is a commonly used assay. The purpose cif this study was to evaluate the test's actual performance in the clinical setting and determine the effects of renal function, grade of bacteremia, and severity-of-illness scores on its outcome. Patients with pneumococcal bacteremia were retrospectively identified and stratified on the basis of glomerular filtration rates, number of positive blood cultures, and CURB-65 scores. Logistic regression was used to determine the effect that these 3 variables had on test outcomes. SP UAg testing was performed in 65 of 129 patients with pneumococcal bacteremia and was positive in 42 of 65 (64.5%). Impaired renal function was the only variable to have a significant effect on test outcome (P = 0.03). Test performance was less sensitive than prospective studies indicate. Patients with impaired renal function were significantly more likely to have positive UAg tests. (C) 2010 Elsevier Inc. All rights reserved.
Selickman J; Paxos M; File T M; Seltzer R; Bonilla H
Diagnostic Microbiology and Infectious Disease
2010
2010-06
Journal Article
<a href="http://doi.org/10.1016/j.diagmicrobio.2010.01.005" target="_blank" rel="noreferrer noopener">10.1016/j.diagmicrobio.2010.01.005</a>