成人呼吸器感染症患者における喀痰と尿を用いた肺炎球菌検出の迅速免疫クロマトグラフィアッセイの性能比較
| Jazyk: | angličtina |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Acta Medica Nagasakiensia. 66(2):71-79 |
| ISSN: | 0001-6055 |
| Popis: | Aim: Streptococcus pneumoniae is the most frequently detected bacterium in pneumonia. RAPIRUN Streptococcus pneumoniae (RAPIRUN) using sputum and BinaxNow Streptococcus pneumoniae (BinaxNow) using urine have been used as rapid diagnostic methods for S. pneumoniae detection in Japan; however, their correlation with quantitative culture tests has not been well evaluated.Methods: A prospective study was conducted on adult patients with respiratory tract infections whose sputum and urine samples were available in six hospitals. Sputum and urine samples were tested at each site, and quantitative sputum cultures were performed. The performance of RAPIRUN and BinaxNow was compared in cases in which quantitative culture showed S. pneumoniae.Results: A total of 192 patients were analyzed. Of these, 167 were diagnosed with pneumonia (87.0%) including 161 of community-acquired pneumonia. Of the 192 cases, 86 (44.8%) were culture-proven for S. pneumoniae. There were 83 and 57 RAPIRUN- and BinaxNow-positive cases, respectively. The sensitivity and specificity of RAPIRUN were 84.9% and 90.6%, respectively, and those of BinaxNOW were 55.8% and 91.5%, respectively, indicating that RAPIRUN was significantly superior in sensitivity (p < 0.0001) with almost equal specificity (p = 0.317). Positive and negative percent agreements of both tests were 59.3% (κ, 0.114 [95% CI, 0.053–0.281]) and 99.1% (κ, 0.942 [95% CI, 0.830–1]), respectively, indicating they were well matched in specificity but not in sensitivity. The positivity rate of RAPIRUN increased with an increase in the number of bacteria (p< 0.0001) but not BinaxNow (p = 0.275).Conclusion: In adult patients with respiratory tract infections in whom sputum collection is feasible, RAPIRUN will increase the diagnostic efficacy of S. pneumoniae infection. 長崎大学学位論文 学位記番号:博(医歯薬)甲第1501号 学位授与年月日:令和5年3月1日 Author: Katsuji Hirano, Masato Tashiro, Takahiro Takazono, Tomo Mihara, Yoshihisa Kohno, Akira Kondo, Toyomitsu Sawai, Kohji Hashiguchi, Kiyoyasu Fukushima, Yuichi Inoue, Naofumi Suyama, Kinichi Izumikawa, Izumi Sato, Katsunori Yanagihara, Hiroshi Mukae, Shigeru Kohno, Koichi Izumikawa Citation: Acta Medica Nagasakiensia, 66(2), pp. 71-79; 2023 |
| Databáze: | OpenAIRE |
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