title: Toward a quantitative DNA-based definition of pneumococcal pneumonia: a comparison of Streptococcus pneumoniae target genes, with special reference to the Spn9802 fragment.
abstract: The current shift from phenotypically toward genotypically based microbial diagnosis is not unproblematic. A novel quantitative real-time polymerase chain reaction (PCR) assay based on the Spn9802 DNA fragment was therefore developed for detection of Streptococcus pneumoniae. Out of 44 bacterial species, only S. pneumoniae and Streptococcus pseudopneumoniae were positive in Spn9802 PCR. In an evaluation on nasopharyngeal aspirates from 166 patients with community-acquired pneumonia, the assay was positive in 49 of 50 culture-positive cases. Of 19 culture-negative but Spn9802 PCR-positive cases, 12 were confirmed as S. pneumoniae by rnpB sequence analysis. With an expanded reference standard, including culture and rnpB sequencing, Spn9802 had a sensitivity of 94% and a specificity of 98%. A cutoff for clinically significant positivity was 10(4) DNA copies/mL, giving 71% sensitivity and 100% specificity. In conclusion, Spn9802 real-time PCR is highly sensitive and specific. The quantification it provides enables differentiation between pneumococcal pathogenicity and commensalism.
authors.affiliation: Department of Clinical Microbiology, Uppsala University Hospital, Uppsala S-751 85, Sweden.
authors.forename: Guma M K
authors.initials: GM
authors.lastname: Abdeldaim
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Strålin
authors.forename: Per
authors.initials: P
authors.lastname: Olcén
authors.forename: Jonas
authors.initials: J
authors.lastname: Blomberg
authors.forename: Björn
authors.initials: B
authors.lastname: Herrmann
mesh_terms: D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics*; D006801:Humans; D010614:Pharynx / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D043262:Ribonuclease P / Q000235:genetics; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D043262:Ribonuclease P