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Comparison of Sputum and Nasopharyngeal Aspirate Samples and of the PCR Gene Targets lytA and Spn9802 for Quantitative PCR for Rapid Detection of Pneumococcal Pneumonia
Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden: Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Microbiology, Faculty of Medicine, Benghazi University, Benghazi, Libyan Arab Jamahiriya; Department of Clinical Mycobacteriology, National Center for Diseases Control, Benghazi, Libyan Arab Jamahiriya.
Department of Laboratory Medicine/Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
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2014 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 52, no 1, 83-89 p.Article in journal (Refereed) Published
Abstract [en]

We aimed to compare sputum and nasopharyngeal aspirate (NpA) samples and the PCR gene targets lytA and Spn9802 in quantitative PCR (qPCR) assays for rapid detection of pneumococcal etiology in community-acquired pneumonia (CAP). Seventy-eight adult patients hospitalized for radiologically confirmed CAP had both good-quality sputum and NpA specimens collected at admission. These samples were subjected to lytA qPCR and Spn9802 qPCR assays with analytical times of < 3 h. Thirty-two patients had CAP with a pneumococcal etiology, according to conventional diagnostic criteria. The following qPCR positivity rates were noted in CAP cases with and without pneumococcal etiology: 96% and 15% (sputum lytA assay), 96% and 17% (sputum Spn9802 assay), 81% and 11% (NpA lytA assay), and 81% and 20% (NpA Spn9802 assay), respectively. The mean lytA and Spn9802 DNA levels were significantly higher in qPCR-positive sputum samples from cases with pneumococcal etiology than in qPCR-positive sputum samples from CAP cases without pneumococcal etiology or qPCR-positive NpA samples from cases with pneumococcal etiology (P < 0.02 for all comparisons). For detection of pneumococcal etiology, receiver operating characteristic curve analysis showed that sputum specimens were superior to NpA specimens as the sample type (P < 0.02 for both gene targets) and lytA tended to be superior to Spn9802 as the gene target. The best-performing test, the sputum lytA qPCR assay, showed high sensitivity (94%) and specificity (96%) with a cutoff value of 10(5) DNA copies/ml. In CAP patients with good sputum production,

Place, publisher, year, edition, pages
American Society for Microbiology , 2014. Vol. 52, no 1, 83-89 p.
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-56727DOI: 10.1128/JCM.01742-13ISI: 000329222400014PubMedID: 24153121ScopusID: 2-s2.0-84891501876OAI: oai:DiVA.org:oru-56727DiVA: diva2:1083928
Note

Funding Agency:

Uppsala-Örebro Regional Research Council 

Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2017-03-23Bibliographically approved

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