Source: Annual Congress 2002 - Acute exacerbations of COPD: aetiology and therapy
Disease area: Airway diseases, Respiratory infections

Abstract

The aim was to determine the possibility to detect Streptococcus pneumoniae (Sp) antigen in urine of stable COPD patients colonized by Sp and to evaluate differences in those with infection exacerbation by Sp.
In a prospective study we include stable COPD outpatients and COPD infectious exacerbations admitted in our hospital, analysing 125 sputum samples. We excluded pneumonia in all cases and reviewed clinical histories in order to discard previous episodes of peumococcal pneumonia (PN). In those with positive sputum culture with Sp we performed pneumococcal polysaccharide capsular antigen (PPCA) by inmunocromatographic membrane test (ICT) using both direct or concentrated urine by selective ultrafiltration.
In 16 sputum cultures (12,8%) we isolated SP, 11 of them from patients with infectious exacerbation of COPD (FEV1 average 35%) and 5 others from stable COPD (FEV1 average 45.5%). We detected PPCA in 4 samples of direct urine and in 9 concentrated samples from patients with infections exacerbations of COPD. In stable COPD colonized by Sp we only detected 1 Sp antigen in concentrated urine samples and none in direct urine. The only patient with stable COPD in whom we detected Sp antigen in concentrated urine had been admitted 4 months previously due to a supposed PN.
The detection of Sp antigen using ICT both in direct and concentrated urine in patients with COPD and bronchial colonization by Sp is uncommon, while in patients with COPD and pneumococcal bronchial infection it may be positive in a high percentage (81.8%) of concentrated urine samples.

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J. Ruiz, F. Andreo, J. Dominguez, J. Casas, A. Rossell, S. Blanco, N. Galí, J. M. Manterola, V. Ausina, J. Morera (Badalona, Spain). Pneumococcal bronchial Infection vs colonization in COPD: differences in urine antigens. Eur Respir J 2002; 20: Suppl. 38, 3369

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