The evaluation of the sputum antigen kit in the diagnosis of pneumococcal pneumonia

Abstract

Objective A previously developed sputum antigen detection kit for Streptococcus pneumoniae enabled the early diagnosis of pneumococcal pneumonia using sputum samples. We conducted a prospective study to compare the sensitivity of the sputum and urinary antigen kits. Methods Pneumonia patients who were treated from April 2014 to September 2015 were recruited for the present study. Patients with pneumococcal pneumonia who could not participate in the prospective arm of the study were analyzed in the retrospective arm. Results Nine of the 69 participants in the prospective study had pneumococcal pneumonia. The sputum antigen kit results correlated well with the sputum culture results. The sensitivity of the sputum antigen kit was 88.9% (8/9), which was higher than that of the urinary antigen kit (5/9; 55.6%). When patients from the retrospective arm of the study were included, the sensitivity of the sputum culture was 93.5% (29/31), which was significantly higher than that of the urinary antigen kit (19/31; 60.6%). False positives were obtained using the sputum antigen kit in four cases. Three of the four false positives were suspected to have resulted from the administration of antibiotics prior to the use of the kit; the remaining case likely occurred due to a false reaction to S. milleri-induced pyothorax. Conclusion Collectively, our findings suggest that the sputum antigen kit has a higher sensitivity for detecting S. pneumoniae than the urinary antigen kit. However, the prior administration of antibiotics can render the sputum culture results negative or lead to a false-positive result.