Insights Into Pneumococcal Pneumonia Using Lung Aspirates and Nasopharyngeal Swabs Collected From Pneumonia Patients in The Gambia

J Infect Dis. 2022 Apr 19;225(8):1447-1451. doi: 10.1093/infdis/jiaa186.


Background: We investigated the pathogenesis of pneumococcal pneumonia using clinical specimens collected for pneumonia surveillance in The Gambia.

Methods: Lung aspirates and nasopharyngeal swabs from 31 patients were examined by culture, quantitative polymerase chain reaction (qPCR), whole genome sequencing, serotyping, and reverse-transcription qPCR.

Results: Five lung aspirates cultured pneumococci, with a matching strain identified in the nasopharynx. Three virulence genes including ply (pneumolysin) were upregulated >20-fold in the lung compared with the nasopharynx. Nasopharyngeal pneumococcal density was higher in pediatric pneumonia patients compared with controls (P < .0001).

Conclusions: Findings suggest that changes in pneumococcal gene expression occurring in the lung environment may be important in pathogenesis.

Keywords: Streptococcus pneumoniae; lung; nasopharynx; pneumococcus; pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Gambia / epidemiology
  • Humans
  • Lung
  • Nasopharynx
  • Pneumococcal Infections* / diagnosis
  • Pneumonia, Pneumococcal* / diagnosis
  • Streptococcus pneumoniae / genetics