Incidence of Streptococcus Pneumoniae Using Urinary Antigen Test in Pneumonic Children Attending Suez Canal University Hospital

Background: Streptococcus pneumoniae is the main etiology of bacterial pneumonia and may additionally cause invasive infections such as meningitis and sepsis, as well as non-invasive ones like sinusitis and otitis media. Aim: To enable early detection of pneumococcal pneumonia using urinary antigen test (UAT (as a non-invasive and rapid screening tool for better management. Patients and methods: This prospective observational research has been carried out at the Pediatric Department and PICU of Suez Canal University Hospital. It included 110 children (1 month–5 years) who were admitted with community-acquired pneumonia (CAP) based on the World Health Organization (WHO) criteria. Results: Among 110 hospitalized children with CAP, 41 cases (37.3%) were tested positive and 69 cases (62.7%) were negative for S. pneumoniae using the UAT. This corresponds to an incidence of 373 cases per 1,000 CAP admissions during the 6-month study period. Fever, cyanosis, and prolonged capillary refill time were significantly more prevalent in UAT-positive patients (p-value below 0.05). All participants presented with tachypnea and cough as per WHO CAP criteria. UAT-positive cases had higher TLC, neutrophils, NLR, and CRP, with lower lymphocyte counts (p < 0.001). Lobar pneumonia was the predominant radiological finding in UAT-positive patients, while interstitial pneumonia, bronchopneumonia, and normal X-rays were more common in UAT-negative cases (p < 0.001). Among UAT-positive children, 70.7% were discharged, while 29.3% died. Conclusion: S. pneumoniae was found in 37.3% of CAP cases using UAT — a quick and reliable tool that helps catch what cultures might miss and guides better treatment decisions.