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Journal of Clinical Microbiology, January 2003, p. 63-66, Vol. 41, No. 1
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.1.63-66.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia

David R. Murdoch,1,2* Trevor P. Anderson,1 Kirsten A. Beynon,1 Alvin Chua,1 Angela M. Fleming,1 Richard T. R. Laing,3 G. Ian Town,3 Graham D. Mills,4 Stephen T. Chambers,2 and Lance C. Jennings1

Microbiology Unit, Canterbury Health Laboratories,1 Department of Pathology,2 Canterbury Respiratory Research Group, Christchurch School of Medicine and Health Sciences, Christchurch,3 Respiratory Department, Waikato Hospital, Hamilton, New Zealand4

Received 18 April 2002/ Returned for modification 4 August 2002/ Accepted 18 October 2002

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia. Plasma or buffy coat samples were PCR positive in only 6 of the 21 patients with positive blood cultures for S. pneumoniae and in 12 other patients (4 of whom had no other laboratory evidence of S. pneumoniae infection). Buffy coat samples from two control patients (neither having evidence of S. pneumoniae infection), but no control plasma samples, were PCR positive. Although pneumococcal antigen was detected in the urine from 120 of 420 (29%) patients, only 4 of 227 (2%) urine samples tested were PCR positive. Overall, 256 of 318 (81%) patients had PCR-positive sputum samples, including 58 of 59 samples from which S. pneumoniae was cultured. Throat swab samples from 229 of 417 (55%) patients were PCR positive and, in those who produced sputum, 96% also had positive PCR results from sputum. Throat swabs from 73 of 126 (58%) control patients were also PCR positive. We conclude that the pneumolysin PCR assay adds little to existing diagnostic tests for S. pneumoniae and is unable to distinguish colonization from infection when respiratory samples are tested.

* Corresponding author. Mailing address: Microbiology Unit, Canterbury Health Laboratories, P.O. Box 151, Christchurch, New Zealand. Phone: 64 3 364 1530. Fax: 64 3 364 0238. E-mail: david.murdoch{at}cdhb.govt.nz.

Journal of Clinical Microbiology, January 2003, p. 63-66, Vol. 41, No. 1
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.1.63-66.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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