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Journal of Clinical Microbiology, October 2009, p. 3308-3312, Vol. 47, No. 10
0095-1137/09/$08.00+0     doi:10.1128/JCM.01071-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Streptococcus pneumoniae DNA Load in Blood as a Marker of Infection in Patients with Community-Acquired Pneumonia {triangledown}

Remco P. H. Peters,1,2,{dagger} Richard F. de Boer,3 Tim Schuurman,3,{ddagger} Sonja Gierveld,1 Mirjam Kooistra-Smid,3 Michiel A. van Agtmael,2 Christina M. J. E. Vandenbroucke-Grauls,1 Maike C. J. Persoons,4 and Paul H. M. Savelkoul1*

Departments of Medical Microbiology & Infection Control,1 Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands,2 Department of Research & Development, Laboratory for Infectious Diseases, Groningen, The Netherlands,3 Department of Medical Microbiology, Scheper Hospital Emmen, Laboratory for Infectious Diseases, Groningen, The Netherlands4

Received 2 June 2009/ Returned for modification 8 July 2009/ Accepted 4 August 2009

Direct detection of Streptococcus pneumoniae DNA in blood adds to culture results in the etiological diagnosis of patients with community-acquired pneumonia (CAP). Quantification of the amount of DNA, the bacterial DNA load (BDL), provides a measurement of DNAemia that may increase the understanding of the clinical relevance of S. pneumoniae DNA in blood. We evaluated the S. pneumoniae BDL as a diagnostic tool in adult patients with CAP. The BDL was determined in whole-blood samples collected simultaneously with blood for culture from 45 adult patients with CAP. After DNA extraction, S. pneumoniae DNA was detected with specific real-time PCR amplification, and the BDL was calculated with a standard curve. PCR and microbiological results were compared, and the BDL was related to clinical and laboratory parameters. S. pneumoniae DNA was detected in 10/13 patients with positive blood cultures and in 67% of patients with microbiologically confirmed pneumococcal pneumonia. The positive predictive values of the receiver operating characteristic curves for the BDLs for pneumococcal infection (100%) and pneumococcal bacteremia (69%) were higher than those for the level of C-reactive protein (CRP; 43% and 23%, respectively) and the white blood cell count (WBC; 42% and 35%, respectively); the negative predictive values of these three parameters were in the same range (±90 and ±97%, respectively). The BDL was higher in patients presenting with systemic inflammatory response syndrome and in patients with bacteremia. Positive correlations were observed for the BDL with WBC, CRP level, and length of stay. We conclude that the BDL supports the diagnosis of S. pneumoniae infection in patients with CAP and provides a putative marker of the severity of disease.

* Corresponding author. Mailing address: VU University Medical Center, Department of Medical Microbiology and Infection Control, P.O. Box 7057, 1007MB Amsterdam, The Netherlands. Phone: 31 20 4440522. Fax: 31 20 4444313. E-mail: p.savelkoul{at}vumc.nl

{triangledown} Published ahead of print on 12 August 2009.

{dagger} Present address: Perinatal HIV Research Unit, Khutso Kurhula Project, University of the Witwatersrand, Tzaneen, South Africa.

{ddagger} Present address: Department of Medical Microbiology, Virology Section, University Medical Center Groningen, Groningen, The Netherlands.

Journal of Clinical Microbiology, October 2009, p. 3308-3312, Vol. 47, No. 10
0095-1137/09/$08.00+0     doi:10.1128/JCM.01071-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • (2009). Pneumococcal DNA Load in CAP. JWatch Infect. Diseases 2009: 2-2 [Full Text]  


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