Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia

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ID: 112006
2003
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Abstract
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia. Plasma or buffy coat samples were PCR positive in only 6 of the 21 patients with positive blood cultures for S. pneumoniae and in 12 other patients (4 of whom had no other laboratory evidence of S. pneumoniae infection). Buffy coat samples from two control patients (neither having evidence of S. pneumoniae infection), but no control plasma samples, were PCR positive. Although pneumococcal antigen was detected in the urine from 120 of 420 (29%) patients, only 4 of 227 (2%) urine samples tested were PCR positive. Overall, 256 of 318 (81%) patients had PCR-positive sputum samples, including 58 of 59 samples from which S. pneumoniae was cultured. Throat swab samples from 229 of 417 (55%) patients were PCR positive and, in those who produced sputum, 96% also had positive PCR results from sputum. Throat swabs from 73 of 126 (58%) control patients were also PCR positive. We conclude that the pneumolysin PCR assay adds little to existing diagnostic tests for S. pneumoniae and is unable to distinguish colonization from infection when respiratory samples are tested.
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murdoch2003journalevaluation Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors David R. Murdoch;Trevor P. Anderson;Kirsten A. Beynon;Alvin Chua;Angela M. Fleming;Richard T. R. Laing;G. Ian Town;Graham D. Mills;Stephen T. Chambers;Lance C. Jennings;David R. Murdoch;Trevor P. Anderson;Kirsten A. Beynon;Alvin Chua;Angela M. Fleming;Richard T. R. Laing;G. Ian Town;Graham D. Mills;Stephen T. Chambers;Lance C. Jennings;
Journal Journal of clinical microbiology
Year 2003
DOI
10.1128/JCM.41.1.63-66.2003
URL
http://dx.doi.org/10.1128/JCM.41.1.63-66.2003
Keywords
National Center for Biotechnology Information NCBI NLM MEDLINE humans pubmed abstract nih national institutes of health national library of medicine research support non-u.s. gov't adult Comparative Study Antigens DNA Evaluation Study Bacterial / analysis Polymerase Chain Reaction / methods* pneumonia streptococcus pneumoniae / genetics streptococcus pneumoniae / isolation & purification* streptococcal infections / microbiology community-acquired infections / microbiology* pneumococcal / diagnosis david r murdoch pmid:12517826 pmc149569 doi:10.1128/jcm.41.1.63-66.2003 trevor p anderson lance c jennings pneumococcal / microbiology* respiratory system / microbiology

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