A new study on lower respiratory tract infections recently tested the BinaxNOW® and Urine Antigen Detection (UAD) assays to detect a common antigen from all pneumococcal strains and the 13 pneumococcal serotypes present in the vaccine Prevenar 13® (PCV13). The study entitled “Pneumococcal lower respiratory tract infections in adults: an observational case-control study in primary care in Belgium” was published in the BMC Family Practice by Johan Flamaing, from the Department of Geriatric Medicine and Clinical and Experimental Medicine, University Hospitals of Leuven, Belgium, along with colleagues.

Lower respiratory tract infections (LRTIs), and in particular community-acquired pneumonia (CAP), cause significant morbidity and mortality in adults, especially in the elderly. CAP is the sixth main cause of death in the United States.

Serious LRTI (SLRTI) etiology cannot be adequately identified through clinical symptoms alone. Clinicians do not routinely request the diagnostic procedures, including chest imaging, sputum and blood recommended by international guidelines. For treatment, antibiotics are typically used to limit and decrease the risk of hospitalization and mortality by pneumococcal pneumonia.

In this study, the research team performed the first studies that combined BinaxNOW® S. pneumonia and UAD tests for identification of pneumococcal infection in urine samples. The primary aims were to evaluate the percentage of S. pneumoniae SLRTI among the overall SLRTIs cases and to evaluate the percentage of serotype specific S. pneumoniae SLRTI using the serotype specific UAD.

The researchers performed a clinical trial (OPUS-B) consisting of a multi-center, prospective, case-controlled, observational study of patients with SLRTI in primary care in Belgium, conducted during the winter period of  2011 and 2013. Urine samples were collected for the BinaxNOW® and UAD assays, and the clinicians were blinded to the results. Overall, the research team found that S. pneumonia was the cause for circa 5% of SLRTIs observed in primary care in Belgium. The infection by Pneumococcal was associated with a significant increase in morbidity, where 68% of serotypes causing SLRTI were potentially preventable by PCV13.

This study contributed to a better understanding of pneumococcal LRTIs in primary care in Europe and particularly in Belgium. In fact, the majority of the findings were produced on pneumococcal invasive disease in hospital conditions, where culture methods to identify the pathogens are available. This is also one of the very few studies to combine BinaxNOW® S. pneumoniae and UAD assays for the identification of pneumococcal antigens in urine samples.