Current pneumococcal vaccines cover the 10 to 23 most common serotypes of the 92 presently described. However, with the increased usage of pneumococcal-serotype-based vaccines, the risk of serotype replacement and an increase in disease caused by nonvaccine serotypes remains. Serotype surveillance of pneumococcal infections relies heavily on culture techniques, which are known to be insensitive, particularly in cases of noninvasive disease. Pneumococcal-serotypespecific urine assays offer an alternative method of serotyping for both invasive and noninvasive disease. However, the assays described previously cover mainly conjugate vaccine serotypes, give little information about circulating nonvaccine serotypes, and are currently available only in one or two specialist laboratories. Our laboratory has developed a Luminex-based extended-range antigen capture assay to detect pneumococcal-serotype-specific antigens in urine samples. The assay targets 24 distinct serotypes/serogroups plus the cell wall polysaccharide (CWP) and some cross-reactive serotypes. We report that the assay is capable of detecting all the targeted serotypes and the CWP at 0.1 ng/ml, while some serotypes are detected at concentrations as low as 0.3 pg/ml. The analytical serotype specificity was determined to be 98.4% using a panel of polysaccharide-negative urine specimens spiked with nonpneumococcal bacterial antigens. We also report clinical sensitivities of 96.2% and specificities of 89.9% established using a panel of urine specimens from patients diagnosed with community-acquired pneumonia or pneumococcal disease. This assay can be extended for testing other clinical samples and has the potential to greatly improve serotype-specific surveillance in the many cases of pneumococcal disease in which a culture is never obtained.KEYWORDS diagnostics, immunization, monoclonal antibodies, pneumococcus, surveillance studies D espite being vaccine preventable, Streptococcus pneumoniae (pneumococcus) remains a major cause of morbidity and mortality worldwide. Pneumococcal disease (PD) includes both invasive and noninvasive disease. The former includes bacteremia and meningitis; the latter, nonbacteremic pneumonia, sinusitis, and acute otitis media. To date, 97 "serotypes" of pneumococcus have been reported (1); however, some of these show only genotypic differences and produce the same polysaccharide structures (2). Ninety-two serotypes are currently described by the Danish system using commercial typing sera from SSI Diagnostica AG (Hillerød, Denmark). These serotypes differ in