Urinary Antigen Testing for Streptococcus pneumoniae

Please note that effective 4th June 2024 urinary antigen testing for Streptococcus pneumoniae antigen will only be available after discussion and approval from a Clinical Microbiologist or Infectious Disease specialist.

This test, which has been increasingly used in the setting of community acquired pneumonia, has sub-optimal sensitivity, and has limited usefulness from an antimicrobial stewardship perspective. There is little evidence to suggest that the test has any impact on clinical outcomes.

It may still be useful in selected patients who are critically unwell, when the results are interpreted carefully.

In addition, antigen testing for Streptococcus pneumoniae may also be useful on pleural fluid when investigating an empyema of unclear origin, and on cerebrospinal fluid in the initial investigation of a presumed bacterial meningitis.

This change brings us into line with other diagnostic laboratories throughout New Zealand.

Hyams C, Williams OM, Williams P. Urinary antigen testing for pneumococcal pneumonia: is there evidence to make its use uncommon in clinical practice? ERJ Open Res 2020;6(1).

DOI: 10.1183/23120541.00223-2019

Falguera M, Ruiz-Gonzalez A, Schoenenberger JA, et al. Prospective, randomised study to compare empirical treatment versus targeted treatment on the basis of the urine antigen results in hospitalised patients with community-acquired pneumonia. Thorax 2010;65:101–106.

DOI: 10.1136/thx.2009.118588