LITERATURE REVIEW: PERBANDINGAN METODE DETEKSI Streptococcus pneumoniae PADA SAMPEL NASOPHARYNGEAL SWAB PADA POPULASI DEWASA
DOI:
https://doi.org/10.36526/biosense.v9i3.8052Keywords:
Kata kunci: Streptococcus pneumoniae; usap nasofaring; quantitative PCR (qPCR); kultur bakteri; metode diagnostikAbstract
Streptococcus pneumoniae merupakan patogen utama penyebab pneumonia komunitas pada populasi dewasa, dengan kolonisasi nasofaring sebagai tahap awal patogenesis. Deteksi bakteri ini menggunakan sampel nasopharyngeal swab (NPS) memiliki peran penting dalam diagnosis dan surveilans, namun performa diagnostiknya bervariasi tergantung metode yang digunakan. Literature review ini bertujuan untuk membandingkan metode deteksi S. pneumoniae pada sampel NPS pada populasi dewasa, dengan fokus pada sensitivitas, spesifisitas, dan implikasi klinis. Kajian dilakukan terhadap artikel publikasi tahun 2015–2026 yang melibatkan populasi dewasa (≥18 tahun) dan menggunakan NPS sebagai spesimen utama atau pembanding. Hasil menunjukkan bahwa metode polymerase chain reaction (PCR), khususnya quantitative PCR (qPCR) dengan target gen lytA dan piaB, memiliki sensitivitas lebih tinggi dibandingkan kultur konvensional yang cenderung underestimasi kolonisasi. Namun, sensitivitas NPS pada dewasa tetap terbatas dibandingkan spesimen lain seperti sputum dan orofaring, terutama pada kasus dengan densitas bakteri rendah. Penggunaan multiplex PCR dan panel molekuler meningkatkan diagnostic yield serta memungkinkan deteksi simultan berbagai patogen pernapasan. Selain metode, faktor usia, lokasi kolonisasi, dan jenis sampel turut memengaruhi hasil deteksi. Disimpulkan bahwa PCR merupakan metode yang lebih sensitif dibandingkan kultur dalam deteksi S. pneumoniae pada NPS dewasa, namun keterbatasan biologis NPS perlu dipertimbangkan sehingga kombinasi metode dan sampel dapat meningkatkan akurasi diagnostik.
Abstract
Streptococcus pneumoniae is a major pathogen responsible for community-acquired pneumonia in adults, with nasopharyngeal colonization representing the initial stage of pathogenesis. Diagnostic detection of this bacterium using nasopharyngeal swab (NPS) specimens plays an important role in clinical diagnosis and surveillance; however, its diagnostic performance varies depending on the method employed. This literature review aimed to compare diagnostic methods for Streptococcus pneumoniae using NPS specimens in adult populations, with a particular focus on sensitivity, specificity, and clinical implications. The review included articles published between 2015 and 2026 involving adult participants (≥18 years) and utilizing NPS as the primary or comparative specimen. The findings indicate that Polymerase Chain Reaction (PCR)-based methods, particularly quantitative PCR (qPCR) targeting the lytA and piaB genes, exhibit higher sensitivity than conventional culture methods, which generally detect lower rates of colonization. Nevertheless, the sensitivity of NPS in adults remains limited compared with other specimen types, such as sputum and oropharyngeal swabs, especially in cases with low bacterial density. The use of multiplex PCR and molecular diagnostic panels enhances diagnostic yield and enables the simultaneous detection of multiple respiratory pathogens. In addition to the diagnostic method, factors such as age, colonization site, and specimen type also influence diagnostic outcomes. In conclusion, PCR is a more sensitive method than conventional culture for the detection of Streptococcus pneumoniae in adult NPS specimens. However, the biological limitations of NPS should be taken into account, and combining diagnostic methods with multiple specimen types may improve overall diagnostic accuracy.
References
Abadio, A. K. R., Kioshima, E. S., Martins, N. F., Maigret, B., Felipe, M. S. S., Freitas, S. M., Maigret, B., Felipe, M. S. S., Abagyan, R. A., Kufareva, I., Totrov, M., Abbasi, M., Sadeghi-Aliabadi, H., Hassanzadeh, F., Amanlou, M., Abdelmonsef, A. H., Dulapalli, R., Dasari, T., Padmarao, L. S., … Olson, A. J. A. J. (2015). A pharmacophore-based virtual screening approach for the discovery of Trypanosoma cruzi GAPDH inhibitors (vol 5, pg 2019, 2013). J Chem Inf Model. https://doi.org/Book_Doi 10.1002/9783527633326
Almeida, S. T. (2020). qPCR increases pneumococcal detection. Scientific Reports, 10, 8373. https://doi.org/10.1038/s41598-020-65156-2
Almeida, S. T., Paulo, A. C., Simões, A. S., Ferreira, B., & Sá-Leão, R. (2025a). Streptococcus pneumoniae carriage in adults during the COVID-19 pandemic in Portugal: dominance of serotypes included in broader PCVs and of serotype 3. MSphere, 10(7), e00082-25.
Almeida, S. T., Paulo, A. C., Simões, A. S., Ferreira, B., & Sá-Leão, R. (2025b). Streptococcus pneumoniae carriage in adults during the COVID-19 pandemic in Portugal. MSphere, 10(7), e00082-25. https://doi.org/10.1128/msphere.00082-25
Almeida, S. T., Pedro, T., Paulo, C., de Lencastre, H., & Sá-Leão, R. (2020a). Re-evaluation of Streptococcus pneumoniae carriage in Portuguese elderly by qPCR. Scientific Reports, 10, 8373. https://doi.org/10.1038/s41598-020-65156-2
Almeida, S. T., Pedro, T., Paulo, C., de Lencastre, H., & Sá-Leão, R. (2020b). Re-evaluation of Streptococcus pneumoniae carriage in Portuguese elderly by qPCR increases carriage estimates and unveils an expanded pool of serotypes. Scientific Reports, 10, 8373.
Bogaert, D., De Groot, R., & Hermans, P. W. (2004). Streptococcus pneumoniae colonisation: the key to pneumococcal disease. The Lancet Infectious Diseases, 4(3), 144–154. https://doi.org/10.1016/S1473-3099(04)00938-7
Demars, Y., Brahier, T., & Rotzinger, D. C. (2022). Utility of polymerase chain reaction in nasopharyngeal swabs. Microbiology Spectrum, 10(3), e00379-22. https://doi.org/10.1128/spectrum.00379-22
Demars, Y., Brahier, T., Rotzinger, D. C., Brouillet, R., Jaton, K., & Opota, O. (2022). Utility of polymerase chain reaction in nasopharyngeal swabs for identifying respiratory bacteria. Microbiology Spectrum, 10(3), e00379-22. https://doi.org/10.1128/spectrum.00379-22
Demars, Y., Brahier, T., Rotzinger, D. C., Brouillet, R., Jaton, K., Opota, O., & Boillat-Blanco, N. (2022). Utility of polymerase chain reaction in nasopharyngeal swabs for identifying respiratory bacteria causing community-acquired pneumonia. Microbiology Spectrum, 10(3), e00379-22.
Erizal, Y. D., Farikh, M., Tiranissa, V., & Sari, W. Y. (2026). Desain Primer MMP-8 dan IL-6 untuk Analisis Ekspresi Gen Jaringan Gusi Rattus norvegicus dengan qRT-PCR. Jurnal Biosense, 9(1), 243–249. https://doi.org/https://doi.org/10.36526/biosense.v9i1.7222
Gillis, H. D., Lang, A. L., ElSherif, M., Martin, I., Hatchette, T. F., McNeil, S. A., & LeBlanc, J. J. (2017). Assessing the diagnostic accuracy of PCR-based detection of Streptococcus pneumoniae from nasopharyngeal swabs collected for viral studies in Canadian adults hospitalised with community-acquired pneumonia. BMJ Open, 7(6), e015008.
Grant, L. R. (2025). Persistence of Vaccine Serotype Carriage. Journal of Infectious Diseases, 231(6), e1045–e1056. https://doi.org/10.1093/infdis/jiad123
Grant, L. R., Sutcliffe, C. G., Littlepage, S., Alexander-Parrish, R., Becenti, L., Isturiz, R. E., & Hammitt, L. L. (2025). Persistence of Vaccine Serotype Carriage and Differences in Pneumococcal Carriage by Laboratory Method and Sample Type in Indigenous Individuals in the Southwest United States. Journal of Infectious Diseases, 231(6), e1045–e1056.
Greiner, O., Day, P. J., Altwegg, M., & Nadal, D. (2001). Quantitative detection of Streptococcus pneumoniae DNA by real-time PCR. Journal of Clinical Microbiology, 39(9), 3129–3134. https://doi.org/10.1128/JCM.39.9.3129-3134.2001
Hackman, J., Hibberd, M. L., Swarthout, T. D., Hinds, J., Ashall, J., Sheppard, C., & Hué, S. (2024). Evaluating methods for identifying and quantifying Streptococcus pneumoniae co-colonization using next-generation sequencing data. Microbiology Spectrum, 12(12), e03643-23.
Holter, J. C. (2015). Etiology of community-acquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in Norway. BMC Infectious Diseases, 15, 64. https://doi.org/10.1186/s12879-015-0803-5
Holter, J. C., Müller, F., Bjørang, O., Samdal, H. H., Marthinsen, J. B., Jenum, P. A., & Heggelund, L. (2015). Etiology of community-acquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in Norway. BMC Infectious Diseases, 15(1), 64.
Kim, K. J., Yun, S. G., Nam, M. H., Lee, C. K., & Cho, Y. (2025). Comparing sputum, nasopharyngeal swabs, and combined samples for respiratory bacterial detection using multiplex PCR. Microbiology Spectrum, 13(3), e02285-24.
Krone, C. L., Wyllie, A. L., & van Beek, J. (2020). Carriage of Streptococcus pneumoniae in adults: challenges in detection. Journal of Clinical Microbiology, 58(9), e01243-20. https://doi.org/10.1128/JCM.01243-20
Lansbury, L. (2024). Carriage of Streptococcus pneumoniae in adults. Journal of Infection, 89(5), 106277. https://doi.org/10.1016/j.jinf.2024.106277
Miellet, W. R., Almeida, S. T., Trzciński, K., & Sá-Leão, R. (2023). Streptococcus pneumoniae carriage studies in adults: Importance, challenges, and key issues to consider when using quantitative PCR-based approaches. Frontiers in Microbiology, 14, 1122276. https://doi.org/10.3389/fmicb.2023.1122276
Nikolaou, E., German, E. L., Blizard, A., Howard, A., Hitchins, L., Chen, T., & Ferreira, D. M. (2021). The nose is the best niche for detection of experimental pneumococcal colonisation in adults of all ages, using nasal wash. Scientific Reports, 11(1), 18279.
O’Brien, K. L., Wolfson, L. J., & Watt, J. P. (2009). Burden of disease caused by Streptococcus pneumoniae. The Lancet, 374(9693), 893–902. https://doi.org/10.1016/S0140-6736(09)61204-6
Sa’adah, M., & Hadi, M. I. (2026). Deteksi Kontaminasi Bakteri Escherichia coli pada Alat Makan Di Beberapa Tempat Makan Di Kabupaten Gresik. Jurnal Biosense, 9(1), 43–54. https://doi.org/https://doi.org/10.36526/biosense.v9i1.6549
Saukkoriipi, A., Palmu, A. A., Pascal, T., Verlant, V., Hausdorff, W. P., & Jokinen, J. (2018). lytA quantitative PCR on sputum and nasopharyngeal swab samples for detection of pneumococcal pneumonia among the elderly. Journal of Clinical Microbiology, 56(1), e01128.
Shabrina, F., Maharani, B., Hariri, M. R., & Turhadi, T. (2025). Optimasi Suhu Annealing Marka Molekuler Simple Sequence Repeat ( SSR ) untuk Studi Keragaman Genetik Aglaonema pictum ( Roxb .) Kunth. 8(4), 55–59. https://doi.org/https://doi.org/10.36526/biosense.v8i4.5695
Sutcliffe, C. G. (2019). Detection of Streptococcus pneumoniae in the nasopharynx. American Journal of Epidemiology, 188, 2110–2119. https://doi.org/10.1093/aje/kwz191
Sutcliffe, C. G., Grant, L. R., Cloessner, E., Klugman, K. P., Vidal, J. E., Reid, R., & Hammitt, L. L. (2019). Association of laboratory methods, colonization density, and age with detection of Streptococcus pneumoniae in the nasopharynx. American Journal of Epidemiology, 188(12), 2110–2119.
Turner, P., & Turner, C. (2011). Improved detection of pneumococcal colonization by PCR. PLoS ONE, 6(3), e24171. https://doi.org/10.1371/journal.pone.0024171
van Deursen, A. M., van den Bergh, M. R., & Sanders, E. A. (2016). Carriage of Streptococcus pneumoniae in asymptomatic, community-dwelling elderly in the Netherlands. Vaccine, 34(1), 4–6.
Velikova, T., Ali, H., Tomov, L., & Velinov, T. (2025). Nasopharyngeal Colonization and Antimicrobial Susceptibility of Bacterial Isolates in Children and Young Adults with Acute , Protracted , and Chronic Cough : A Cross-Sectional Bulgarian Study. Acta Microbiologica Hellenica, 70(1), 1–12. https://doi.org/https://doi.org/10.3390/amh70010010
Vuichard, D. (2016). PCR detection in nasal vs nasopharyngeal. Open Forum Infectious Diseases, 3, ofw172. https://doi.org/10.1093/ofid/ofw172.63
Wyllie, A. L., Rots, N. Y., Wijmenga-Monsuur, A. J., van Houten, M. A., Sanders, E. A., & Trzciński, K. (2023). Saliva as an alternative sample type for detection of pneumococcal carriage in young children. Microbiology, 169(10), 1394.
Yasuda, I., Suzuki, M., Dhoubhadel, B. G., Terada, M., Satoh, A., Sando, E., & Morimoto, K. (2020). The low carriage prevalence of pneumococcus among community-dwelling older people: A cross-sectional study in Japan. Vaccine, 38(21), 3752–3758.
Zacharioudakis, I. M., Zervou, F. N., Dubrovskaya, Y., Inglima, K., See, B., & Aguero-Rosenfeld, M. (2021). Evaluation of a multiplex PCR panel for the microbiological diagnosis of pneumonia in hospitalized patients: experience from an academic medical center. International Journal of Infectious Diseases, 104, 354–360.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 JURNAL BIOSENSE

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

















