Sheppard C L, Salmon J E, Harrison T G, Lyons M, George R C
Respiratory and Systemic Infection Laboratory, Health Protection Agency, Centre for Infections, London, UK.
Epidemiol Infect. 2008 Jul;136(7):922-7. doi: 10.1017/S0950268807009302. Epub 2007 Aug 16.
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.
2003年期间，英国一个城市中50岁以下的患者出现了一组起初病因不明的肺炎病例（两例死亡）。常规培养检测结果不明确，不过，怀疑是肺炎球菌感染，于是采用非培养方法对假定的疫情进行了调查。对10名患者的临床样本进行了肺炎球菌聚合酶链反应（PCR）和多位点序列分型（MLST）检测，或进行了Binax NOW肺炎球菌尿抗原检测以及血清型特异性酶联免疫吸附测定（ELISA）。死亡患者的肺样本PCR呈阳性，并产生了不同的MLST类型。一个家族组中的两名患者肺炎球菌1型抗原呈阳性。另有两名患者1型抗原呈阳性，一名患者4型抗原呈阳性。两例抗原阳性病例血清PCR也呈阳性。非培养方法确诊了6例病例的病因。血清型和MLST结果显示并非单一疫情，而是在肺炎球菌肺炎高发背景下出现的一个家族聚集性病例群，提供了原本无法获得的重要流行病学数据。
