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Oropharyngeal production of pneumococcal capsular antigen and the potential for contamination of expectorated sputum samples in pneumococcal pneumonia

Published online by Cambridge University Press:  15 May 2009

P. Venkatesan ,
K. Sole ,
C. Tang ,
J. T. Macfarlane  and
R. G. Finch
P. Venkatesan
Affiliation:
Departments of Microbiology, The University of Nottingham, The City Hospital, Hucknall Rd, Nottingham NG5 1PB
K. Sole
Affiliation:
PHLS Laboratory, Queen’s Medical Centre, Nottingham, UK
C. Tang
Affiliation:
Respiratory Medicine, The City Hospital
J. T. Macfarlane
Affiliation:
Respiratory Medicine, The City Hospital
R. G. Finch
Affiliation:
Departments of Microbiology, The University of Nottingham, The City Hospital, Hucknall Rd, Nottingham NG5 1PB
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The presence of pneumococcal capsular antigen (PCA) in the oropharynx was sought in subjects without respiratory tract infection. Saliva specimens from 239 subjects were analysed by counter-current immunoelectrophoresis using ‘Omni-serum’. 15.5% gave positive reactions but only 24% of positive samples were typable and therefore due to pneumococcal or pneumococcal-like antigens. Given that oropharyngeal production of antigens occurs we investigated whether PCA in expectorated sputum arose from oropharyngeal contamination. Sixteen patients with pneumococcal pneumonia, and with sputum positive for PCA, were investigated in detail. On the basis of serotyping and concentration the PCA in sputum was thought to arise from the lower respiratory tract in all cases. This was confirmed by a simple, novel approach involving the comparison of concentrations in concomitant samples of saliva and sputum. Thus while oropharyngeal production of antigens poses a potential diagnostic problem the latter approach can be used to exclude contamination.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 3 , June 1993 , pp. 621 - 631
Copyright
Copyright © Cambridge University Press 1993

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