Rapid identification of Streptococcus pneumoniae in blood cultures by using the ImmuLex, Slidex and Wellcogen latex agglutination tests and the BinaxNOW antigen test

  • O. Altun
  • S. Athlin
  • M. Almuhayawi
  • K. Strålin
  • V. ÖzenciEmail author
Original Article


Rapid identification of Streptococcus pneumoniae in blood culture (BC) bottles is important for early directed antimicrobial therapy in pneumococcal bacteraemia. We evaluated a new latex agglutination (LA) test on BC bottles, the ImmuLex™ S. pneumoniae Omni (Statens Serum Institut, Denmark), and compared the performance with the Slidex® pneumo-Kit (bioMérieux, France) and the Wellcogen™ S. pneumoniae (Remel, UK) LA tests, as well as the BinaxNOW® S. pneumoniae (Alere, USA) antigen test. The four tests were directly applied on 358 positive BC bottles with Gram-positive cocci in pairs or chains and on 15 negative bottles. Valid test results were recorded in all cases for ImmuLex and BinaxNOW and in 88.5 % (330/373) and 94.1 % (351/373) of cases for Slidex and Wellcogen, respectively. Based on bottles positive for S. pneumoniae by conventional methods, the sensitivity of ImmuLex was 99.6 %, similar to the other tests (range, 99.6–100 %). Based on bottles positive for non-pneumococcal pathogens, the specificity of ImmuLex was 82.6 %, in comparison to 97.6 % for Slidex (p < 0.01) and 85.4 % for Wellcogen (p = ns). The BinaxNOW test had a lower specificity (64.1 %) than any LA test (p < 0.01). On BC bottles positive for α-haemolytic streptococci, ImmuLex was positive in 12/67 (17.9 %) cases, Slidex in 2/59 (3.4 %) cases, Wellcogen in 11/64 (17.2 %) cases and BinaxNOW in 25/67 (37.3 %) cases. In conclusion, the ImmuLex test provides a valid and sensitive technique for the rapid detection of S. pneumoniae in BC bottles, similar to the other compared methods. However, the specificity was sub-optimal, since the test may cross-react with other Gram-positive bacteria.


Blood Culture Bottle Latex Agglutination Test Enterococcus Species Test Circle Blood Culture System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank SSI Diagnostica, bioMérieux, Remel and Alere for providing the tests evaluated in this study. We gratefully acknowledge the support from Camilla Borg and the other staff members at the clinical microbiology laboratory at Karolinska University Hospital Huddinge, Stockholm, Sweden. Data from the manuscript were presented at the 55th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Diego, California, USA, September 17–21 2015.

Compliance with ethical standards

This study was performed in accordance with the Declaration of Helsinki and with the ethical standards of the research committee in Stockholm, Sweden.

Conflict of interest

The authors declare no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • O. Altun
    • 1
  • S. Athlin
    • 2
  • M. Almuhayawi
    • 1
    • 4
  • K. Strålin
    • 3
  • V. Özenci
    • 1
    Email author
  1. 1.Division of Clinical Microbiology F 72Karolinska Institutet, Karolinska University HospitalHuddingeSweden
  2. 2.Department of Infectious Diseases, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
  3. 3.Department of Infectious DiseasesKarolinska Institutet, Karolinska University HospitalHuddingeSweden
  4. 4.Department of Microbiology, Faculty of MedicineKing Abdul-Aziz UniversityJeddahSaudi Arabia

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