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The Relevance of a Novel Quantitative Assay to Detect up to 40 Major Streptococcus pneumoniae Serotypes Directly in Clinical Nasopharyngeal and Blood Specimens

机译:直接检测临床鼻咽和血液样本中多达40种主要肺炎链球菌血清型的新型定量分析方法的相关性

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摘要

For epidemiological and surveillance purposes, it is relevant to monitor the distribution and dynamics of Streptococcus pneumoniae serotypes. Conventional serotyping methods do not provide rapid or quantitative information on serotype loads. Quantitative serotyping may enable prediction of the invasiveness of a specific serotype compared to other serotypes carried. Here, we describe a novel, rapid multiplex real-time PCR assay for identification and quantification of the 40 most prevalent pneumococcal serotypes and the assay impacts in pneumonia specimens from emerging and developing countries. Eleven multiplex PCR to detect 40 serotypes or serogroups were optimized. Quantification was enabled by reference to standard dilutions of known bacterial load. Performance of the assay was evaluated to specifically type and quantify S. pneumoniae in nasopharyngeal and blood samples from adult and pediatric patients hospitalized with pneumonia (n = 664) from five different countries. Serogroup 6 was widely represented in nasopharyngeal specimens from all five cohorts. The most frequent serotypes in the French, South African, and Brazilian cohorts were 1 and 7A/F, 3 and 19F, and 14, respectively. When both samples were available, the serotype in blood was always present as carriage with other serotypes in the nasopharynx. Moreover, the ability of a serotype to invade the bloodstream may be linked to its nasopharyngeal load. The mean nasopharyngeal concentration of the serotypes that moved to the blood was 3 log-fold higher than the ones only found in the nasopharynx. This novel, rapid, quantitative assay may potentially predict some of the S. pneumoniae serotypes invasiveness and assessment of pneumococcal serotype distribution.
机译:为了流行病学和监测目的,监测肺炎链球菌血清型的分布和动态很重要。常规的血清分型方法不能提供有关血清型负荷的快速或定量信息。与携带的其他血清型相比,定量血清分型可以预测特定血清型的侵袭性。在这里,我们描述了一种新颖,快速的多重实时PCR分析方法,用于鉴定和定量40种最流行的肺炎球菌血清型以及该方法对新兴和发展中国家肺炎标本的影响。优化了用于检测40种血清型或血清群的11种多重PCR。参照已知细菌载量的标准稀释液进行定量。评估了该测定的性能,以特异性分类和量化来自五个国家的因肺炎住院的成年和儿科患者(n = 664)的鼻咽和血液样本中的肺炎链球菌。血清群6在所有五个队列的鼻咽标本中都有广泛的代表。在法国,南非和巴西队列中,最常见的血清型分别为1和7A / F,3和19F和14。当两个样品都可用时,血液中的血清型总是与鼻咽中的其他血清型一起携带。而且,血清型侵入血液的能力可能与其鼻咽负荷有关。转移到血液中的血清型的平均鼻咽浓度比仅在鼻咽中发现的浓度高3个对数倍。这种新颖,快速,定量的测定方法可能潜在地预测某些肺炎链球菌血清型的侵袭性和肺炎球菌血清型分布的评估。

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