Rapid identification of Streptococcus pneumoniae serotypes by cpsB gene-based sequetyping combined with multiplex PCR

J Microbiol Immunol Infect. 2022 Oct;55(5):870-879. doi: 10.1016/j.jmii.2021.11.004. Epub 2021 Nov 29.


Background/purpose: Streptococcus pneumoniae is an important human pathogen that causes invasive infections in adults and children. Accurate serotyping is important to study its epidemiological distribution and to assess vaccine efficacy.

Methods: Invasive S. pneumoniae isolates (n = 300) from 27 teaching hospitals in China were studied. The Quellung reaction was used as the gold standard to identify the S. pneumoniae serotypes. Subsequently, multiplex PCR and cpsB gene-based sequetyping methods were used to identify the serotypes.

Results: Based on the Quellung reaction, 299 S. pneumoniae isolates were accurately identified to the serotype level and 40 different serotypes were detected. Only one strain was non-typeable, and five most common serotypes were identified: 23F (43, 14.3%), 19A (41, 13.7%), 19F (41, 13.7%), 3 (31, 10.3%), and 14 (27, 9.0%). Overall, the multiplex PCR method identified 73.3 and 20.7% of the isolates to the serotype and cluster levels, respectively, with 1.7% of the isolates misidentified. In contrast, the cpsB sequetyping method identified 59.0 and 30.3% of the isolates to the serotype and cluster levels, respectively, and 7% were misidentified.

Conclusions: The cpsB gene sequetyping method combined with multiplex PCR, can greatly improve the accuracy and efficiency of serotyping, besides reducing the associated costs.

Keywords: Multiplex PCR; Quellung reaction; Serotype; Streptococcus pneumoniae; cpsB sequetyping.

MeSH terms

  • Adult
  • Child
  • Humans
  • Multiplex Polymerase Chain Reaction / methods
  • Pneumococcal Infections*
  • Pneumonia*
  • Serogroup
  • Serotyping / methods
  • Streptococcus pneumoniae