title: Evaluation of phenotypic and molecular methods for identification of Streptococcus pneumoniae.
abstract: OBJECTIVE
  The objective of this study is to compare various Streptococcus pneumoniae identification methods.
  
  
  METHODS
  In total, 1371 putative S. pneumoniae isolates were tested with three phenotypic methods and a molecular-based method targeting a virulence factor (CpsA). We assessed the sensitivity and the specificity of each method and widely used S. pneumoniae identification algorithm.
  
  
  RESULTS
  None of the methods or the identification algorithm used separately was able to correctly identify all S. pneumoniae isolates. Furthermore, a high rate of optochin resistance was found.
  
  
  CONCLUSIONS
  We demonstrated the failure of the current S. pneumoniae identification methods and optochin susceptibility-based algorithm. In addition, the high rate of optochin resistance might justify the necessity of a close monitoring of optochin susceptibility.
authors.affiliation: Departement of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Medical Microbiology, Haga Hospital, The Hague, The Netherlands.
authors.forename: Rachid Y
authors.initials: RY
authors.lastname: Yahiaoui
authors.affiliation: Departement of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Casper D J
authors.initials: CD
authors.lastname: den Heijer
authors.affiliation: Departement of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Petra
authors.initials: P
authors.lastname: Wolfs
authors.affiliation: Departement of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Cathrien A
authors.initials: CA
authors.lastname: Bruggeman
authors.affiliation: Departement of Medical Microbiology, Maastricht University Medical Centre, Maastricht, The Netherlands.|National Institute for Public Health & the Environment, RIVM, Bilthoven, The Netherlands.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism; D001426:Bacterial Proteins / Q000235:genetics; D001431:Bacteriological Techniques / Q000379:methods*; D001433:Bacteriolysis / Q000187:drug effects; D001646:Bile / Q000378:metabolism; D005060:Europe; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009297:Nasal Mucosa / Q000382:microbiology; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology; D011803:Quinine / Q000031:analogs & derivatives / Q000378:metabolism; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C500439:CpsA protein, Streptococcus pneumoniae; C017303:ethylhydrocupreine; D011803:Quinine
keywords: PCR; Streptococcus pneumoniae; bile solubility; colony morphology; identification; optochin