title: Use of a serotype-specific urine immunoassay to determine the course of a hospital outbreak ofStreptococcus pneumoniaecomplicated by influenza A.
abstract: BACKGROUND
  An outbreak ofStreptococcus pneumoniae(pneumococcal) infection complicated by concomitant influenza A on an elderly care ward was detected.
  
  
  METHODS
  Thirteen patients with hospital-acquired respiratory infections were investigated during the course of the outbreak investigation. Six had a positive BinaxNOWS. pneumoniaeurinary 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 forS. pneumoniaeantigen.
  
  
  CONCLUSIONS
  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,S. pneumoniaeserotype-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.
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England , 61 Colindale Avenue, London NW9 5EQ , UK.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Sheppard
authors.affiliation: Department of Microbiology & Virology, Epsom & St Helier University Hospitals NHS Trust , UK.
authors.forename: John
authors.initials: J
authors.lastname: Clark
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England , 61 Colindale Avenue, London NW9 5EQ , UK.
authors.forename: Mary P E
authors.initials: MP
authors.lastname: Slack
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England , 61 Colindale Avenue, London NW9 5EQ , UK.
authors.forename: Norman K
authors.initials: NK
authors.lastname: Fry
authors.affiliation: Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England , 61 Colindale Avenue, London NW9 5EQ , UK.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Harrison
keywords: Diagnosis; Pneumococcus; influenza; outbreak; respiratory; urine antigen