背景:BinaxNOW肺炎链球菌尿抗原检测试剂盒(BinaxNOW)的敏感性,通过包括生命体征在内的一些变量进行调整,实验室检查和肺炎严重程度,一直在下降是未知的。本研究的目的是调查BinaxNOW敏感性最近是否下降,并确定BinaxNOW结果的预测因子。包括时间趋势。
方法:这项前瞻性队列研究纳入了2001年1月至2015年12月在仓县中心医院住院的连续肺炎球菌社区获得性肺炎患者。肺炎球菌社区获得性肺炎定义为血液或胸腔积液或痰培养结果阳性。为了评估时间趋势对BinaxNOW敏感性的影响,进行时间序列回归分析。此外,BinaxNOW结果的预测因子通过多变量分析使用诸如性别,生命体征,血液检查如C反应蛋白,白蛋白,血尿素氮,肌酐,白细胞计数,血细胞比容和血小板,抗生素预处理,菌血症,和肺炎的严重程度,除了时间趋势和季节性。
结果:共纳入446例患者。BinaxNOW敏感性显示出显著的,从2001年(81.3%)到2015年(48.7%)逐渐下降。在多变量分析[优势比(95%置信区间)]上,菌血症[2.516(1.387-4.561),P=0.002]是BinaxNOW阳性结果的预测因子,而男性[0.467(0.296-0.736),P=0.001],白细胞计数[0.959(0.930-0.989),P=0.008]和每年的时间趋势[0.900(0.859-0.943),P<0.001]是BinaxNOW阴性结果的预测因子。
结论:BinaxNOW的敏感性在15年内下降。在日常临床实践中解释BinaxNOW结果时,我们应该小心,并有望开发出具有良好灵敏度的新试剂盒。
背景:UMIN000004353。
BACKGROUND: Whether the sensitivity of the BinaxNOW Streptococcus pneumoniae urinary antigen test kit (BinaxNOW), adjusted by some variables including vital signs, laboratory examinations and pneumonia severity, has been decreasing is unknown. The aim of the present study was to investigate whether BinaxNOW sensitivity has decreased recently and to identify the predictors of the BinaxNOW result, including the time trend.
METHODS: This prospective cohort study enrolled consecutive patients with pneumococcal community-acquired pneumonia who were hospitalised at Kurashiki Central Hospital from January 2001 to December 2015. Pneumococcal community-acquired pneumonia was defined as positive blood or pleural effusion or sputum culture results. To evaluate the effect of the time trend for the sensitivity of BinaxNOW, time series regression analysis was performed. In addition, predictors of the BinaxNOW result were examined by multivariable analysis using variables such as sex, vital signs, blood tests such as C-reactive protein, albumin, blood urea nitrogen, creatinine, white blood cell count, haematocrit and platelets, antibiotic pre-treatment, bacteraemia, and pneumonia severity, in addition to time trend and seasonality.
RESULTS: A total of 446 patients were included. BinaxNOW sensitivity showed a significant, gradual decrease from 2001 (81.3%) to 2015 (48.7%). On multivariable analysis [odds ratio (95% confidence interval)], bacteraemia [2.516 (1.387-4.561), P = 0.002] was a predictor of a positive BinaxNOW result, whereas male sex [0.467 (0.296-0.736), P = 0.001], white blood cell count [0.959 (0.930-0.989), P = 0.008] and the time trend per year [0.900 (0.859-0.943), P < 0.001] were predictors of a negative BinaxNOW result.
CONCLUSIONS: The sensitivity of BinaxNOW decreased over a 15-year period. We should be careful when interpreting BinaxNOW results in daily clinical practice, and the development of a new kit with good sensitivity is anticipated.
BACKGROUND: UMIN000004353.