Streptococcus Pneumoniae Urinary Antigen Test and Acute Exacerbations of Chronic Obstructive Pulmonary Disease

• Published in: COPD: Journal of Chronic Obstructive Pulmonary Disease Vol. 9; no. 4; pp. 344 - 351
• Main Authors: Nishimura, Koichi, Nishimura, Takashi, Oga, Toru
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.08.2012; Taylor & Francis; Informa UK Limited
• Subjects: Acute Disease; Acute exacerbations of chronic obstructive pulmonary disease; Adult; Aged; Aged, 80 and over; Antigens, Bacterial; Antigens, Bacterial - urine; Chronic obstructive pulmonary disease; Disease Progression; Female; Hospitalization; Humans; Longitudinal Studies; Male; Middle Aged; Pneumococcal Infections; Pneumococcal Infections - complications; Pneumococcal Infections - diagnosis; Pneumococcal Infections - urine; Pneumonia, Pneumococcal; Pneumonia, Pneumococcal - complications; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Pneumococcal - urine; Pulmonary Disease, Chronic Obstructive; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - microbiology; Pulmonary Disease, Chronic Obstructive - urine; Sputum; Sputum - microbiology; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Streptococcus pneumoniae - isolation & purification; Urinary antigen
• ISSN: 1541-2555; 1541-2563; 1541-2563
• DOI: 10.3109/15412555.2012.668250

Abstract Background : Streptococcus pneumoniae is one of the most common bacteria identified in sputum obtained from subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Purpose : To examine the urinary pneumococcal antigen test in subjects admitted with AECOPD and subjects with COPD, and to evaluate its relationship with AECOPD. Methods: Urine samples from 82 subjects with AECOPD involved in 122 consecutive hospitalizations were tested. Additionally, 196 consecutive subjects with stable COPD were tested a total of 607 times at intervals greater than 6 months. Results: Pneumococcal antigen was positive in 14 (17.1%) out of all 82 subjects first hospitalized with AECOPD. It was positive in 7 (20.6%) out of the 34 subjects with pneumonic exacerbations of COPD, and in 7 (14.6%) out of the 48 subjects with non-pneumonic exacerbations of COPD. Two subjects with non-pneumonic S. pneumoniae-related AECOPD were identified, and they both tested positive. A total of 607 urinary antigen tests were performed on stable COPD subjects, and 16 (2.6%) specimens were positive. Colonization by S. pneumoniae was found in the sputum of only 25% of the COPD subjects with positive urinary pneumococcal antigen test results. Conclusion: The results of the pneumococcal urinary antigen test were similar for AECOPD subjects with and without pneumonia. This test may be a useful method for preventing the under-diagnosis of S. pneumoniae-related exacerbations of COPD. The detection of pneumococcal antigen in the urine is not related to the persistent colonization of the respiratory mucosa by S. pneumoniae.