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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1975 Oct;28(10):801–806. doi: 10.1136/jcp.28.10.801

Counter-current immunoelectrophoresis for the diagnosis of pneumococcal chest infection.

M El-Refaie, C Dulake
PMCID: PMC475864  PMID: 2621

Abstract

Counter-current immunoelectrohporesis is a rapid sensitive method for detecting pneumococcal capsular antigens in sputum. A result can be obtained within 45 minutes. The optimum conditions for performing the test are given. Counter-current immunoelectrophoresis works with all the 33 pneumococcal antigens tested except type 14. Better precipitin lines are obtained when the gel-support is acid (pH 6-6) than when it is alkaline (pH 8-6). Omniserum is as effective as group-specific sera for the identification of pneumococcal capsular antigens. The findings suggest that pneumococcal infection was present in 44% of 300 unselected suspected chest infections. Culture for pneumococci was positive in only 15% of these cases. The clinical importance of these findings is still being studied but our experience has shown that patients with chest infections should have effective antipneumococcal antibiotics as part of their regimen and that the laboratory diagnosis may be made quickly and accurately by counter-current immunoelectrophoresis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRUMFITT W., WILLOUGHBY M. L., BROMLEY L. L. An evaluation of sputum examination in chronic bronchitis. Lancet. 1957 Dec 28;273(7009):1306–1309. doi: 10.1016/s0140-6736(57)91637-9. [DOI] [PubMed] [Google Scholar]
  2. CLIFTON M., POWNALL M., STUART-HARRIS C. H. Observations on the carriage of pneumococci by patients with chronic bronchitis, and their families. J Hyg (Lond) 1955 Jun;53(2):225–233. doi: 10.1017/s0022172400000693. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. COOPER A. W., WILLIAMSON G. M., ZINNEMANN K., EDWARDS G. F., THORNTON H. Chronic bronchitis. Changes in the bacterial flora of the sputum associated with exacerbations and long-term antibacterial treatment. Br J Dis Chest. 1961 Jan;55:23–29. doi: 10.1016/s0007-0971(61)80020-x. [DOI] [PubMed] [Google Scholar]
  4. Calder M. A., Schonell M. E. Pneumococcal typing and the problem of endogenous or exogenous reinfection in chronic bronchitis. Lancet. 1971 Jun 5;1(7710):1156–1159. doi: 10.1016/s0140-6736(71)91663-1. [DOI] [PubMed] [Google Scholar]
  5. Coonrod J. D., Rytel M. W. Detection of type-specific pneumococcal antigens by counterimmunoelectrophoresis. II. Etiologic diagnosis of pneumococcal pneumonia. J Lab Clin Med. 1973 May;81(5):778–786. [PubMed] [Google Scholar]
  6. Crofton J. The John Barnwell Lecture. The chemotherapy of bacterial respiratory infections. Am Rev Respir Dis. 1970 Jun;101(6):841–859. doi: 10.1164/arrd.1970.101.6.841. [DOI] [PubMed] [Google Scholar]
  7. Dixon J. M., Miller D. C. Value of dilute inocula in cultural examination of sputum. Lancet. 1965 Nov 20;2(7421):1046–1048. doi: 10.1016/s0140-6736(65)90572-6. [DOI] [PubMed] [Google Scholar]
  8. Dorff G. J., Coonrod J. D., Rytel M. W. Detection by immunoelectrophoresis of antigen in sera of patients with pneumococcal bacteraemia. Lancet. 1971 Mar 20;1(7699):578–579. doi: 10.1016/s0140-6736(71)91169-x. [DOI] [PubMed] [Google Scholar]
  9. Edwards E. A. Immunologic investigations of meningococcal disease. I. Group-specific Neisseria meningitidis antigens present in the serum of patients with fulminant meningococcemia. J Immunol. 1971 Feb;106(2):314–317. [PubMed] [Google Scholar]
  10. Hahn H. H., Beaty H. N. Transtracheal aspiration in the evaluation of patients with pneumonia. Ann Intern Med. 1970 Feb;72(2):183–187. doi: 10.7326/0003-4819-72-2-183. [DOI] [PubMed] [Google Scholar]
  11. Johanson W. G., Jr, Pierce A. K., Sanford J. P., Thomas G. D. Nosocomial respiratory infections with gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med. 1972 Nov;77(5):701–706. doi: 10.7326/0003-4819-77-5-701. [DOI] [PubMed] [Google Scholar]
  12. Kenny G. E., Wentworth B. B., Beasley R. P., Foy H. M. Correlation of circulating capsular polysaccharide with bacteremia in pneumococcal pneumonia. Infect Immun. 1972 Oct;6(4):431–437. doi: 10.1128/iai.6.4.431-437.1972. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. LAURENZI G. A., POTTER R. T., KASS E. H. Bacteriologic flora of the lower respiratory tract. N Engl J Med. 1961 Dec 28;265:1273–1278. doi: 10.1056/NEJM196112282652601. [DOI] [PubMed] [Google Scholar]
  14. LEES A. W., MCNAUGHT W. Non-tuberculous bacterial flora of sputum and of the upper and lower respiratory tract in pulmonary tuberculosis. Lancet. 1959 Dec 19;2(7112):1115–1117. doi: 10.1016/s0140-6736(59)90100-x. [DOI] [PubMed] [Google Scholar]
  15. LUND E. POLYVALENT, DIAGNOSTIC PNEUMOCOCCUS SERA. Acta Pathol Microbiol Scand. 1963;59:533–536. doi: 10.1111/j.1699-0463.1963.tb01256.x. [DOI] [PubMed] [Google Scholar]
  16. Lund E. Types of pneumococci found in blood, spinal fluid and pleural exudate during a period of 15 years (1954-1969). Acta Pathol Microbiol Scand B Microbiol Immunol. 1970;78(3):333–336. doi: 10.1111/j.1699-0463.1970.tb04311.x. [DOI] [PubMed] [Google Scholar]
  17. Spencer R. C., Philp J. R. Effect of previous antimicrobial therapy on bacteriological findings in patients with primary pneumonia. Lancet. 1973 Aug 18;2(7825):349–350. doi: 10.1016/s0140-6736(73)93192-9. [DOI] [PubMed] [Google Scholar]
  18. Spencer R. C., Savage M. A. Letter: Pneumococcal antigen in sputum. Lancet. 1974 May 18;1(7864):988–988. doi: 10.1016/s0140-6736(74)91294-x. [DOI] [PubMed] [Google Scholar]
  19. Tugwell P., Greenwood B. M. Letter: Bacteriological findings in pneumonia. Lancet. 1974 Jan 19;1(7847):95–95. doi: 10.1016/s0140-6736(74)92317-4. [DOI] [PubMed] [Google Scholar]
  20. Tugwell P., Greenwood B. M. Pneumococcal antigen in lobar pneumonia. J Clin Pathol. 1975 Feb;28(2):118–123. doi: 10.1136/jcp.28.2.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Verhoef J., Jones D. M. Letter: Pneumococcal antigen in sputum. Lancet. 1974 May 4;1(7862):879–879. doi: 10.1016/s0140-6736(74)90544-3. [DOI] [PubMed] [Google Scholar]

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