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The clinical and public health value of non-culture methods in the investigation of a cluster of unexplained pneumonia cases

  • C. L. SHEPPARD (a1), J. E. SALMON (a2), T. G. HARRISON (a1), M. LYONS (a2) and R. C. GEORGE (a1)...

Summary

During 2003, a cluster of initially unexplained pneumonia cases (two fatal) occurred in patients aged <50 years in a British city. Routine culture tests were inconclusive, however, pneumococcal infection was suspected and the putative outbreak was investigated using non-culture methods. Clinical samples from ten patients were tested by pneumococcal polymerase chain reaction (PCR) and multi-locus sequence typing (MLST), or Binax NOW® pneumococcal urine antigen test and serotype-specific enzyme-linked immunosorbent assay (ELISA). Lung samples from the deceased patients were PCR positive and yielded different MLST types. Two patients in one family group were serotype 1 pneumococcal antigen positive. Two further patients were serotype 1 antigen positive, and one serotype 4 positive. Two antigen-positive cases were also serum PCR positive. Non-culture methods confirmed the disease aetiology in six cases. Serotype and MLST results showed no single outbreak, but a family cluster of cases in a high background of pneumococcal pneumonia, providing important epidemiological data that would not otherwise have been available.

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Copyright

Corresponding author

*Author for correspondence: Dr C. L. Sheppard, Respiratory and Systemic Infection Laboratory, Health Protection Agency – Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: carmen.sheppard@hpa.org.uk)

References

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The clinical and public health value of non-culture methods in the investigation of a cluster of unexplained pneumonia cases

  • C. L. SHEPPARD (a1), J. E. SALMON (a2), T. G. HARRISON (a1), M. LYONS (a2) and R. C. GEORGE (a1)...

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