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Editorials |

The Urinary Antigen Test for the Diagnosis of Pneumococcal Pneumonia

Gene R. Pesola, MD, MPH
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Affiliations: New York, NY 
 ,  Dr. Pesola is from the Divisions of Epidemiology and Biostatistics, Columbia School of Public Health.

Correspondence to: Gene R. Pesola, MD, MPH, Divisions of Epidemiology and Biostatistics, The Mailman School of Public Health, Columbia University at 168th St, 600 West 168th St, Ph18, New York, NY 10032



Chest. 2001;119(1):9-11. doi:10.1378/chest.119.1.9
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Pneumonia, the leading cause of death in 1900, is currently the sixth-leading cause of death when combined with influenza,1 and necessitates hospitalization in> 485,000 noninstitutionalized adults in the United States each year, with approximately 43,000 deaths.23 Estimates suggest that 77% of pneumonia occurrences are treated in the outpatient setting4; this would extrapolate to > 2 million pneumonia occurrences each year in the nonpediatric population. Approximately one sixth to one fifth of hospitalized adults are believed to have streptococcal pneumonia (pneumococcus), based on the assumption of a 25 to 30% bacteremic rate.3,5 Etiologic estimation of the outpatient adult population with pneumonia is difficult due to the lack of data, but a few studies57 suggest that 9% or more are pneumococcal in origin. Overall evidence suggests that despite a slowly declining estimated incidence of > 50% of pneumonias in the 1960s, at least in hospitalized patients,89 to < 25% of pneumonias currently based on outpatients and inpatients with pneumonia, the pneumococcus is presently still the number-one cause of adult pneumonia. Therefore, any diagnostic test that can improve the diagnosis of pneumonia in general, and in particular the most common pneumonia, would be of particular benefit to the primary-care physician who is meeting the patient at the initial point of care.

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