ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2012
Use of a rapid test of pneumococcal colonization density to diagnose pneumococcal pneumonia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers.
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Who cites it
80 citing papers in PubMed, 135 citations in OpenAlex.
- Diagnostic utility of oropharyngeal swabs as an alternative to lower respiratory tract samples for PCR-based syndromic testing in patients with community-acquired pneumonia.Journal of clinical microbiology · 2023Trial
- Etiology of community-acquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in Norway.BMC infectious diseases · 2015Trial
- Effect of age and vaccination with a pneumococcal conjugate vaccine on the density of pneumococcal nasopharyngeal carriage.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Trial
- Diagnosis of pneumococcal pneumonia using quantitative PCR targeting lytA and piaB in adult patients with community-acquired pneumonia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Fluorescence-based index from the SofiaMicrobiology spectrum · 2026Article
- Nasopharyngeal carriage of Streptococcus pneumoniae among Brazilian children: Interplay with viral co-infection.PloS one · 2025Article
- Limited protection of pneumococcal vaccines against emergent Streptococcus pneumoniae serotype 14/ST876 strains.Infection · 2024Article
- Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment.Clinical and experimental pediatrics · 2024Article
- Antibiotics for lower respiratory tract infection in children presenting in primary care: ARTIC-PC RCT.Health technology assessment (Winchester, England) · 2023Article
- Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia.Microorganisms · 2023Article
- The quorum sensing com system regulates pneumococcal colonisation and invasive disease in a pseudo-stratified airway tissue model.Microbiological research · 2023Article
- Utility of Polymerase Chain Reaction in Nasopharyngeal Swabs for Identifying Respiratory Bacteria Causing Community-Acquired Pneumonia.Microbiology spectrum · 2022Article
- Streptococcus pneumoniae colonization in health care professionals at a tertiary university pediatric hospital.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Comparison of pneumococcal colonization density among healthy children and children with respiratory symptoms using real time PCR (RT-PCR).BMC microbiology · 2022Article
- Antigen-Presenting Cells in the Airways: Moderating Asymptomatic Bacterial Carriage.Pathogens (Basel, Switzerland) · 2021Review
- Assessment of nasopharyngeal Streptococcus pneumoniae colonization does not permit discrimination between Canadian children with viral and bacterial respiratory infection: a matched-cohort cross-sectional study.BMC infectious diseases · 2021Article
- Intestinal helminth co-infection is an unrecognised risk factor for increased pneumococcal carriage density and invasive disease.Scientific reports · 2021Article
- Colonization With Extensively Drug-ResistantFrontiers in medicine · 2021Article
- Diagnosis of Streptococcus pneumoniae infection using circulating antibody secreting cells.PloS one · 2021Article
- Nasal Pneumococcal Density Is Associated with Microaspiration and Heightened Human Alveolar Macrophage Responsiveness to Bacterial Pathogens.American journal of respiratory and critical care medicine · 2020Article
20 more citing papers are in PubMed but not listed here.
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundThere is major need for a more sensitive assay for the diagnosis of pneumococcal community-acquired pneumonia (CAP). We hypothesized that pneumococcal nasopharyngeal (NP) proliferation may lead to microaspiration followed by pneumonia. We therefore tested a quantitative lytA real-time polymerase chain reaction (rtPCR) on NP swab samples from patients with pneumonia and controls.
methodsIn the absence of a sensitive reference standard, a composite diagnostic standard for pneumococcal pneumonia was considered positive in South African human immunodeficiency virus (HIV)-infected adults hospitalized with radiographically confirmed CAP, if blood culture, induced good-quality sputum culture, Gram stain, or urinary Binax demonstrated pneumococci. Results of quantitative lytA rtPCR in NP swab samples were compared with quantitative colony counts in patients with CAP and 300 HIV-infected asymptomatic controls.
resultsPneumococci were the leading pathogen identified in 76 of 280 patients with CAP (27.1%) using the composite diagnostic standard. NP colonization density measured by lytA rtPCR correlated with quantitative cultures (r = 0.67; P < .001). The mean lytA rtPCR copy number in patients with pneumococcal pneumonia was 6.0 log(10) copies/mL, compared with patients with CAP outside the composite standard (2.7 log(10) copies/mL; P < .001) and asymptomatic controls (0.8 log(10) copies/mL; P < .001). A lytA rtPCR density ≥8000 copies/mL had a sensitivity of 82.2% and a specificity of 92.0% for distinguishing pneumococcal CAP from asymptomatic colonization. The proportion of CAP cases attributable to pneumococcus increased from 27.1% to 52.5% using that cutoff.
conclusionsA rapid molecular assay of NP pneumococcal density performed on an easily available specimen may significantly increase pneumococcal pneumonia diagnoses in adults.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.