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Volume 169, Issue 10

Saliva as an alternative sample type for detection of pneumococcal carriage in young children Open Access

Abstract

For children, the gold standard for the detection of pneumococcal carriage is conventional culture of a nasopharyngeal swab. Saliva, however, has a history as one of the most sensitive methods for surveillance of pneumococcal colonization and has recently been shown to improve carriage detection in older age groups. Here, we compared the sensitivity of paired nasopharyngeal and saliva samples from PCV7-vaccinated 24-month-old children for pneumococcal carriage detection using conventional and molecular detection methods. Nasopharyngeal and saliva samples were collected from 288 24-month-old children during the autumn/winter, 2012/2013. All samples were first processed by conventional diagnostic culture. Next, DNA extracted from all plate growth was tested by qPCR for the presence of the pneumococcal genes and and a subset of serotypes. By culture, 161/288 (60 %) nasopharyngeal swabs tested positive for pneumococcus, but detection was not possible from saliva due to abundant polymicrobial growth on culture plates. By qPCR, 155/288 (54 %) culture-enriched saliva samples and 187/288 (65 %) nasopharyngeal swabs tested positive. Altogether, 219/288 (76 %) infants tested positive for pneumococcus, with qPCR-based carriage detection of culture-enriched nasopharyngeal swabs detecting significantly more carriers compared to either conventional culture (<0.001) or qPCR detection of saliva (=0.002). However, 32/219 (15 %) carriers were only positive in saliva, contributing significantly to the overall number of carriers detected (=0.002). While testing nasopharyngeal swabs by qPCR proved most sensitive for pneumococcal detection in infants, saliva sampling could be considered as complementary to provide additional information on carriage and serotypes that may not be detected in the nasopharynx and may be particularly useful in longitudinal studies, requiring repeated sampling of study participants.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): carriage , molecular diagnostics , saliva , streptococci and Streptococcus pneumoniae
Funding
This study was supported by the:
  • Pfizer Pharmaceuticals (Award WS2312079 and WS2312119)
    • Principle Award Recipient: KrzysztofTrzciński
  • Dutch Ministry of Health
© 2023 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2023-10-11
2024-05-20
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Saliva as an alternative sample type for detection of pneumococcal carriage in young children
Microbiology 169, 001394 (2023); https://doi.org/10.1099/mic.0.001394
/content/journal/micro/10.1099/mic.0.001394
/content/journal/micro/10.1099/mic.0.001394
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