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Updated: Mar 19, 2026
Capsular Serotyping of Streptococcus pneumoniae by Latex Agglutination
Published on: September 25, 2014
Two cases of serotypeable and non-serotypeable variants of Streptococcus pneumoniae detected simultaneously during
Kedibone M Ndlangisa1,2, Mignon du Plessis3,4, Mushal Allam3
1Centre for Respiratory Diseases and Meningitis (CRDM), National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, Johannesburg, South Africa. kedibonen@nicd.ac.za.
Background:
More than 94 serotypes of Streptococcus pneumoniae have been described to date, however the majority of disease is caused by approximately 20 serotypes. Some pneumococci do not react with commercially available antisera used for serotyping and are thus regarded as non-serotypeable (NT). These pneumococci are commonly isolated during carriage studies and very rarely cause invasive disease. Colonization may occur with more than one serotype however disease with more than one serotype is rarely detected. Thus there are limited data describing cases of pneumococcal disease caused by more than one isolate.
Results:
In two cases of invasive pneumococcal disease in South Africa, a non-serotypeable and a serotypeable isolate were co-detected during routine serotyping. A serotype 1 and 18C isolate were each co-detected with a non-serotypeable isolate in 2009 (case A) and 2010 (case B), from cerebrospinal fluid and blood, respectively. Both patients were 10-14 years old. For case A, the serotypeable isolate could not be obtained due to low representation in the mixed culture. Using electron microscopy we confirmed lack of capsule for the non-serotypeable isolates. Comparison of the case A non-serotypeable isolate with a serotype 1 genome revealed only the presence of the rhamnose biosynthesis genes (rmlA, B, C and D) in the capsular locus, all other capsular genes were absent. Nonetheless it had a multilocus sequence type (ST) associated with serotype 1 (ST217 and ribosomal ST3462) and its core genome clustered with other ST217 isolates. The case B non-serotypeable isolate had all serotype 18C capsular genes except for variation in the wchA and wze genes, compared to the 18C isolate. Both case B isolates were ST9817 and their core genomes were identical.
Conclusions:
The ability of pneumococci to alter capsule production is a potential vaccine escape mechanism and therefore non-serotypeable pneumococci should be monitored as such organisms may increase under vaccine pressure.
Insights
Non-serotypeable Streptococcus pneumoniae, often found during carriage, rarely cause invasive disease. Two cases revealed co-detection of non-serotypeable and serotypeable pneumococci, highlighting potential vaccine escape mechanisms.
Area of Science:
- Microbiology
- Genomics
- Vaccinology
Background:
- Streptococcus pneumoniae has over 94 serotypes, but disease is mainly caused by ~20.
- Non-serotypeable (NT) pneumococci lack detectable capsules and are common in carriage but rare in invasive disease.
Observation:
- Two South African cases of invasive pneumococcal disease involved co-detection of NT and serotypeable isolates.
- Electron microscopy confirmed lack of capsule in NT isolates.
- Genomic analysis revealed NT isolates with partial or absent capsular genes but associated sequence types.
Findings:
- Case A: NT isolate with only rhamnose biosynthesis genes in the capsular locus, but with serotype 1-associated sequence type.
- Case B: NT isolate with variations in serotype 18C capsular genes, sharing sequence type and core genome with the serotypeable isolate.
Implications:
- Altered capsule production in pneumococci can be a vaccine escape mechanism.
- Monitoring NT pneumococci is crucial as they may increase under vaccine pressure.
