title: Genetic diversity of the pneumococcal capsule: implications for molecular-based serotyping.
abstract: Streptococcus pneumoniae remains an important pathogen despite licensure of a seven-valent pneumococcal protein conjugate vaccine. As a result, serotyping strains remains of paramount importance to both assess the effectiveness of current vaccines and closely monitor for the emergence of nonvaccine strains. Given the limitations of the quellung reaction, both molecular and immunology-based serotyping methods have been pursued. Currently, the most promising assay combines an immunologic assay with multiplex PCR of serotype-specific genes. The key limitation with a molecular-based assay is the plasticity of the pneumococcus, as capsular transformation or point mutations could easily result in serotype misclassification. Based on the currently available techniques, a comprehensive immunology-based assay appears to be the most promising alternative to the quellung reaction. In the future, assays that utilize high-throughput sequencing technology and/or matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) could lead to a novel pneumococcal serotyping method.
authors.affiliation: Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, USA. mary.mcellistrem@va.gov
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: McEllistrem
mesh_terms: D016667:Bacterial Capsules / Q000235:genetics* / Q000276:immunology; D015373:Bacterial Typing Techniques / Q000379:methods*; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D013058:Mass Spectrometry / Q000379:methods; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016133:Polymerase Chain Reaction / Q000379:methods; D017422:Sequence Analysis, DNA / Q000379:methods; D012703:Serotyping / Q000379:methods; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification