An outbreak of (pneumococcal) infection complicated by concomitant influenza A on an elderly care ward was detected.

Case presentation:

Thirteen patients with hospital-acquired respiratory infections were investigated during the course of the outbreak investigation. Six had a positive BinaxNOW urinary antigen test and two patients had culture-confirmed pneumococcal bacteraemia and a positive urine antigen test. Five patients gave positive influenza A PCR results of which two were also positive for antigen.


The concurrence of influenza and pneumococcal infections made tracking the course of the infection difficult. This case study shows how the use of a sensitive, serotype-specific urine antigen assay, in the absence of cultured isolates, helped determine whether patients were infected with the same pneumococcal serotype. This was particularly useful when additional respiratory symptoms were seen following the administration of chemoprophylaxis.


Article metrics loading...

Loading full text...

Full text loading...



  1. Birtles A., McCarthy N., Sheppard C. L., Rutter H., Guiver M., Haworth E., George R. C. 2005; Multilocus sequence typing directly on DNA from clinical samples and a cultured isolate to investigate linked fatal pneumococcal disease in residents of a shelter for homeless men. J Clin Microbiol 43:2004–2008 [View Article][PubMed]
    [Google Scholar]
  2. Gupta A., Khaw F. M., Stokle E. L., George R. C., Pebody R., Stansfield R. E., Sheppard C. L., Slack M., Gorton R., Spencer D. A. 2008; Outbreak of Streptococcus pneumoniae serotype 1 pneumonia in a United Kingdom school. BMJ 337:a2964 [View Article][PubMed]
    [Google Scholar]
  3. Nuorti J. P., Butler J. C., Crutcher J. M., Guevara R., Welch D., Holder P., Elliott J. A. 1998; An outbreak of multidrug-resistant pneumococcal pneumonia and bacteremia among unvaccinated nursing home residents. N Engl J Med 338:1861–1868 [View Article][PubMed]
    [Google Scholar]
  4. Pichon B., Moyce L., Sheppard C., Slack M., Turbitt D., Pebody R., Spencer D. A., Edwards J., Krahé D., George R. 2010; Molecular typing of pneumococci for investigation of linked cases of invasive pneumococcal disease. J Clin Microbiol 48:1926–1928 [View Article][PubMed]
    [Google Scholar]
  5. Sheppard C. L., Harrison T. G., Smith M. D., George R. C. 2011; Development of a sensitive, multiplexed immunoassay using xMAP beads for detection of serotype-specific Streptococcus pneumoniae antigen in urine samples. J Med Microbiol 60:49–55 [View Article][PubMed]
    [Google Scholar]
  6. Thomas H. L., Gajraj R., Slack M.P.E., Sheppard C., Hawkey P., Gossain S., Drew C. M., Pebody R. G. 2015; An explosive outbreak of Streptococcus pneumoniae serotype-8 infection in a highly vaccinated residential care home, England, summer 2012. Epidemiol Infect 143:1957–1963 [CrossRef]
    [Google Scholar]

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error