Figures
- FIGURE 1
Study population: seven emergency departments. UAT: urine antigen test; CAP: community-acquired pneumonia; HCAP: healthcare-associated pneumonia; ICU: intensive care unit.
- FIGURE 2
Percentage of positive results by pathogen among study patients with identified pathogens. “Other” includes respiratory viruses, Stenotrophomonas, Prevotella, Peptostreptococcus and other Streptococcal species.
- FIGURE 3
Changes in antibiotic therapy among patients with positive Streptococcus urinary antigen tests.
Tables
- TABLE 1
Clinical parameters for community-acquired pneumonia patients stratified by whether a urine antigen test was obtained.
Variable Urinary antigen test p-value Obtained (n=931) Not obtained (n=1365) Age years 63 (50–76) 68 (51–81) <0.001 Male 458 (49.1) 622 (45.5) 0.10 Intensive care unit 486 (52.2) 430 (31.5) <0.001 PaO2/FiO2 260.5 (202.4–319.1) 269.5 (226.2–319.1) <0.001 Pleural effusion 134 (14.4) 229 (16.8) 0.14 eCURB 0.03 (0.014–0.08) 0.028 (0.014–0.072) 0.13 sCAP minor 2 (1–3) 2 (1–2) 0.001 CURB-65 score 0.28 0 260 (27.9) 352 (25.7) 1 273 (29.3) 428 (31.3) 0.32 2 285 (30.6) 426 (31.2) 0.8 3 97 (10.4) 143 (10.5) 1 4 16 (1.7) 12 (0.9) 0.11 5 0 4 (0.3) 0.15 Data are presented as n (%) or median (interquartile range), unless otherwise stated. sCAP minor is the number of minor criteria for severe community-acquired pneumonia from the Infectious Diseases Society of America/American Thoracic Society 2007 community-acquired pneumonia guidelines 2007 and eCURB is the validated electronic version of CURB-65 (confusion, blood urea, respiratory rate, blood pressure, age 65 years) with weighted, continuous variables yielding a point estimate for 30-day mortality [13, 14]. PaO2: arterial oxygen tension; FiO2: fraction of inspired oxygen.
- TABLE 2
Clinical parameters for healthcare-associated pneumonia patients, stratified by whether a urine antigen test was obtained
Variable Urinary antigen test p-value Obtained (n=179) Not obtained (n=362) Age years 68 (55–80) 70 (57–81) 0.47 Male 76 (42.5) 184 (50.8) 0.08 Intensive care unit 99 (55.3) 168 (46.4) 0.06 PaO2/FiO2 248.2 (191.9–303.8) 252.2 (203.0–337.6) 0.20 Pleural effusion 50 (27.9) 108 (29.8) 0.72 eCURB 0.043 (0.019–0.134) 0.047 (0.019–0.116) 0.94 sCAP minor 2 (1–3) 2 (1–3) 0.64 CURB-65 score 0 30 (16.8) 55 (15.2) 0.73 1 57 (31.8) 106 (29.3) 0.61 2 55 (30.7) 132 (36.5) 0.22 3 29 (16.2) 55 (15.2) 0.86 4 7 (3.9) 13 (3.6) 1 5 1 (0.6) 1 (0.3) 0.55 Data are presented as n (%) or median (interquartile range), unless otherwise stated. sCAP minor is the number of minor criteria for severe community-acquired pneumonia from the Infectious Diseases Society of America/American Thoracic Society 2007 community-acquired pneumonia guidelines 2007 and eCURB is the validated electronic version of CURB-65 (confusion, blood urea, respiratory rate, blood pressure, age 65 years) with weighted, continuous variables yielding a point estimate for 30-day mortality [13, 14]. PaO2: arterial oxygen tension; FiO2: fraction of inspired oxygen.
- TABLE 3
Clinical parameters for patients with a positive UAT, stratified by antibiotic therapy
Variable Antibiotic therapy No change (n=38) De-escalation (n=76) Targeted (n=20) Age years 58.5 (49.25–75) 63 (50.5–74.25) 57.5 (46.75–70.25) Male 18 (47.4) 37 (48.7) 10 (50) Intensive care unit 28 (73.7) 48 (63.2) 12 (60) PaO2/FiO2 217.2 (178.4–274.8) 252.2 (204.9–303.8) 303.8 (214.5–360.5) Pleural effusion 3 (7.9) 12 (15.8) 1 (5) eCURB 0.053 (0.023–0.162) 0.04 (0.019–0.082) 0.028 (0.015–0.054) sCAP minor 3 (2–3) 2 (1–3) 1 (0.75–2) CURB-65 score 0 6 (15.8) 12 (15.8) 7 (35) 1 10 (26.3) 25 (32.9) 8 (40) 2 16 (42.1) 30 (39.5) 5 (25) 3 6 (15.8) 7 (9.2) 0 4 0 2 (2.6) 0 5 0 0 0 Data are presented as n (%) or median (interquartile range), unless otherwise stated. sCAP minor is the number of minor criteria for severe community-acquired pneumonia from the Infectious Diseases Society of America/American Thoracic Society 2007 community-acquired pneumonia guidelines 2007 and eCURB is the validated electronic version of CURB-65 (confusion, blood urea, respiratory rate, blood pressure, age 65 years) with weighted, continuous variables yielding a point estimate for 30-day mortality [13, 14]. PaO2: arterial oxygen tension; FiO2: fraction of inspired oxygen.
