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Forekomst og diagnostik af invasive pneumokokinfektioner
Engelsk titel: Incidence and diagnosis of invasive pneumococcal disease Läs online Författare: Agerbaek Jörgensen M ; Deutch S ; Möller BK ; Östergaard LJ Språk: Dan Antal referenser: 39 Dokumenttyp: Översikt UI-nummer: 04061262

Tidskrift

Ugeskrift for Laeger 2004;166(22)2133-7 ISSN 0041-5782 E-ISSN 1603-6824 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

Invasive pneumococcal disease is defined as pneumonia, meningitis and sepsis caused by Streptococcus pneumoniae . Approximately 7,000 hospital admissions in Denmark each year are caused by pneumococcal pneumonia, 935 patients have pneumococcal sepsis, and there are about 110 admissions for pneumococcal meningitis. These numbers correspond to values from other European countries, Australia and the United States. The frequency of pneumococcal disease is highest among children and elderly people and substantially higher in developing countries than in industrialized countries. The reasons for this are not known, but factors such as smoking, poor housing conditions, poor nutrition and genetic factors are found to be associated with pneumococcal infections. The mortality rate among patients with invasive pneumococcal infections is between 10 and 35%, highest among patients with meningitis or sepsis. There are no methods available to make a fast and correct diagnosis of infections caused by S. pneumoniae . The new urin-ary antigen test based on immune chromatography has a high specificity for detecting pneumococcal pneumonia in adults; the sensitivity has varied in different trials from 52 to 100%. In meningitis and sepsis, the diagnostic value of the antigen test is not well documented. The urinary antigen test could be indicated in the following clinical situations: (1) Pneumonia in which antibiotic treatment with atypical agents is being considered. (2) Pneumonia in which the patient is not responding to penicillin treatment, even though a good response was expected. The value of the antigen test in primary health care remains to be clarified.