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Journal of Clinical Microbiology, March 1998, p. 669-673, Vol. 36, No. 3
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Prospective Study To Determine Clinical Relevance of Detection of Pneumococcal DNA in Sera of Children by PCR

Ron Dagan,1,* Ofra Shriker,2 Inbal Hazan,2 Eugene Leibovitz,1 David Greenberg,1 Francis Schlaeffer,3 and Rachel Levy2

Pediatric Infectious Disease Unit,1 Infectious Disease Laboratory,2 and Department of Internal Medicine,3 Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Received 21 August 1997/Returned for modification 17 October 1997/Accepted 9 December 1997

We undertook a prospective study to evaluate the accuracy of PCR of serum (aimed at the pneumococcal pneumolysin gene) at detecting pneumococcal infections in infants and children. The assay was positive for all blood and cerebrospinal fluid culture-positive samples and for 38 and 44% of patients with lobar pneumonia and acute otitis media, respectively. It was positive for 17% of healthy controls. There was a marked effect of age on the rate of positivity among healthy controls, with the highest rate (33%) being in 2-year-old children, the age group with the highest rate of nasopharyngeal (NP) carriage; the lowest rate was found among infants <2 months of age (13%) and adults ages 18 to 50 years (0%), age groups with the lowest NP pneumococcal carriage rates. Carriers of pneumococci in the nasopharynges had a higher rate of positivity than noncarriers of pneumococci in the nasopharynges for all groups. Our results suggest that although PCR of serum is a sensitive test for the detection of Streptococcus pneumoniae in sterile fluids, its high rate of positivity for healthy controls, related to NP pneumococcal carriage, might exclude it from being useful in detecting deep-seated pneumococcal infections.

* Corresponding author. Mailing address: Pediatric Infectious Disease Unit, Soroka University Medical Center, P.O. Box 151, Hanesiim St., Beer-Sheva 84101, Israel. Phone: (972-7) 640 0547. Fax: (972-7) 623 2334. E-mail: rdagan{at}bgumail.bgu.ac.il.

Journal of Clinical Microbiology, March 1998, p. 669-673, Vol. 36, No. 3
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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