Evidence map›Paper›PMID 42690274›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026

Diagnosis of pneumococcal pneumonia using quantitative PCR targeting lytA and piaB in adult patients with community-acquired pneumonia.

Nienke Paternotte, Willem R Miellet, Tessa Nieuwenhuijsen, Rob Mariman, Wil A van der Reijden, Wouter Rozemeijer, Elisabeth A M Sanders, Dominic Snijders, Cornelis H van Werkhoven, Marc J M Bonten and 2 more

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Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Nienke PaternotteJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584, CG, Utrecht, The Netherlands. N.Paternotte-2@umcutrecht.nl.
Willem R MielletDepartment of Paediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Tessa NieuwenhuijsenDepartment of Paediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Rob MarimanCentre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Wil A van der ReijdenLaboratory of Medical Microbiology, OLVG Lab, Amsterdam, The Netherlands.
Wouter RozemeijerDepartment of Medical Microbiology, Northwest Clinics, Alkmaar, The Netherlands.
Elisabeth A M SandersDepartment of Paediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Dominic SnijdersDepartment of Pulmonary Medicine, Spaarne Hospital, Haarlem, The Netherlands.
Cornelis H van WerkhovenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584, CG, Utrecht, The Netherlands.
Marc J M BontenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584, CG, Utrecht, The Netherlands.
Krzysztof Trzciński *Department of Paediatric Immunology and Infectious Diseases, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Wim G Boersma *Department of Pulmonary Medicine, Northwest Clinics, Alkmaar, The Netherlands.

Funding

Merck Sharp & Dohme Corp. study ID# MISP 60183
6 · The paper itself

Abstract

purposeAccurate diagnosis of pneumococcal pneumonia remains challenging due to suboptimal sensitivity of conventional microbiological methods. Molecular techniques may improve Streptococcus pneumoniae detection, but their clinical utility remains uncertain.

methodsIn this prospective observational study, we compared conventional diagnostics with qPCR-based detection of lytA and piaB genes in nasopharyngeal, oropharyngeal, saliva, and sputum samples collected from adults with community-acquired pneumonia (CAP) and three control groups without acute respiratory symptoms. Stringent sample-specific cut-offs (

resultsS. pneumoniae was detected by conventional methods in 53 (21.1%) of 251 CAP patients. Overall pneumococcal detection by qPCR was higher in CAP patients than in 564 individuals without CAP (35.9% vs. 10.3%, p < 0.001), but pneumococcal density showed substantial overlap between CAP patients and controls and across aetiological groups within the CAP cohort. Using the

conclusionsqPCR targeting lytA and piaB increased pneumococcal detection in CAP patients, but substantial overlap in pneumococcal density limited its added diagnostic value for PCAP. Using stringent lowCq criteria, qPCR identified only a small number of additional PCAP cases beyond conventional diagnostics. Our findings do not support routine use of qPCR as a stand-alone diagnostic test for PCAP. Nevertheless, sputum-based molecular detection may contribute to future surveillance studies when combined with serotype-specific analyses.

Indexed as

Community-acquired pneumoniaPneumococcal colonisationQuantitative PCRRespiratory tract samplesStreptococcus pneumoniae

Identifiers

PMID42690274

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