Huijts SM, et al. - Researchers performed a prospective, observational, cohort study involving patients with community-acquired pneumonia (CAP) presenting to the emergency department (ED) to determine the value of clinical predictors available in the ED in predicting Streptococcus pneumoniae as the cause of CAP. Based on either bacteremia, or S. pneumoniae being cultured from sputum, or urinary immunochromatographic assay positivity, or positivity of a novel serotype-specific urinary antigen detection test, they determined the pneumococcal etiology of CAP. Pneumococcal CAP was identified in 328 of 1,057 patients with CAP. This study yielded nine independent predictors for pneumococcal pneumonia, but because of low positive predictive values or a small yield, this prediction model displayed disappointing clinical utility. For diagnosing pneumococcal CAP, clinical criteria seem to be insufficient. Based on findings, the investigators emphasized the necessity for rapid antigen detection tests to diagnose S. pneumoniae at the time of hospital admission.