Pneumonia最新文献

{"title":"Clinical effectiveness of oral antiviral treatment for non-hospitalized high-risk patients with COVID-19 during Omicron JN.1 subvariant wave: a US-based propensity-matched cohort study.","authors":"Wan-Hsuan Hsu, Bo-Wen Shiau, Po-Yu Huang, Ya-Wen Tsai, Jheng-Yan Wu, Ting-Hui Liu, Min-Hsiang Chuang, Shu-Farn Tey, Lun-Wu Hung, Chih-Cheng Lai","doi":"10.1186/s41479-025-00168-w","DOIUrl":"10.1186/s41479-025-00168-w","url":null,"abstract":"<p><strong>Background: </strong>This real-world study aimed to assess the effectiveness of novel oral antiviral agents in managing COVID-19 among high-risk patients during the Omicron JN.1 subvariant wave.</p><p><strong>Methods: </strong>Data from the TriNetX US network were analyzed using a multi-institutional propensity score matching (PSM) analysis. High-risk non-hospitalized adults with COVID-19 were included, and patients receiving oral antiviral agents (study group) were compared to those not receiving antiviral agents (control group). Primary outcomes included all-cause emergency department (ED) visits, hospitalizations, or death within 30 days.</p><p><strong>Results: </strong>Among 67,495 high-risk patients identified, 17,852 received oral antiviral agents (study group) and 49,643 did not (control group). After PSM, two matched cohorts of 17,847 patients each were established. The study group receiving antiviral agents exhibited a significantly lower risk of primary composite outcome during the 30-day follow-up period compared to the control group (HR, 0.77; 95% CI, 0.72-0.84). Regarding the secondary outcomes, the study group consistently exhibited a significantly lower risk of all-cause ED visits (4.2% vs. 5.4%; HR, 0.78; 95% CI, 0.71-0.86), hospitalization (2.8% vs. 3.3%; HR, 0.86; 95% CI, 0.77-0.97), and mortality (0.1% vs. 0.3%; HR, 0.17; 95% CI, 0.08-0.35) than the control group. Subgroup analyses showed consistent benefits across various demographic and clinical characteristics, except in individuals with booster vaccination.</p><p><strong>Conclusions: </strong>Oral antiviral agents significantly reduced the risk of adverse outcomes among high-risk COVID-19 patients during the Omicron JN.1 subvariant wave. These findings support the potential benefits of oral antiviral therapy in treating COVID-19, particularly in high-risk populations.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"12"},"PeriodicalIF":8.5,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest tube drainage versus repeated therapeutic thoracentesis for the management of pleural infections: a retrospective multicentre propensity-matched study.","authors":"Marion Charron, Victor Roy, Christophe Gut-Gobert, Etienne-Marie Jutant, Louis Leclere, Baptiste Hourmant, Jean-Claude Meurice, Stéphane Jouneau, David Luque Paz","doi":"10.1186/s41479-025-00167-x","DOIUrl":"10.1186/s41479-025-00167-x","url":null,"abstract":"<p><strong>Background: </strong>Drainage of infected pleural fluid is pivotal in the management of pleural infections, either by chest tube drainage (CTD) or repeated therapeutic thoracocentesis (RTT), in association with the use of intrapleural fibrinolytic therapy (IPFT) and DNase.</p><p><strong>Methods: </strong>The aim of this study was to compare the efficacy and the safety of these two methods of pleural drainage. We conducted a multicenter retrospective study, which included all the patients who was hospitalized for suspected pleural infection in three university hospitals between 2012 and 2021 drained by CTD or RTT. A propensity-score matching was performed to compare patients drained by RTT (RTT group) and by chest tube (CTD group) with adjunctive IPFT and DNase.</p><p><strong>Results: </strong>Two hundred and twenty-nine patients with suspected pleural infection were included. After a propensity-score matching, 78 patients were included in the final analysis, divided in two groups of 39 patients each. Patients in RTT group had a reduced length of drainage (6 days [4.3-8] vs 9 [6.5-13], OR = 1.41, 95%CI [1.05-1.89]) and a reduced length of hospital stay (15 days [11.5-21.5] vs 21 [14-30.5], OR = 1.28, 95%CI [1.01-1.61]). There was no significant difference in mortality rates, surgical referral, relapse, and drainage-related complications between the two groups.</p><p><strong>Conclusions: </strong>The management of pleural infections through RTT with IPFT and DNase appears to be as effective and as safe as CTD. Randomized controlled trials comparing RTT and CTD would be required to confirm these results.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"13"},"PeriodicalIF":8.5,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest drainage or repeated thoracentesis for pleural infections: a clinical dilemma.","authors":"Carmine Salerni, Michele Mondoni, Giovanni Sotgiu","doi":"10.1186/s41479-025-00170-2","DOIUrl":"10.1186/s41479-025-00170-2","url":null,"abstract":"<p><p>Pleural infection is a key clinical challenge, especially in immunocompromised patients and in those with pulmonary comorbidities. Its incidence has increased owing to antibiotic resistance and aging of the population. While international guidelines recommend chest tube (CTD) placement for complicated parapneumonic effusions (CPPE), the optimal strategy for fluid drainage is debated. Repeated therapeutic thoracentesis (RTT) could be an alternative to help patient mobility and reduce infectious risk. Studies on RTT demonstrated efficacy similar to that of CTD, mainly when combined with intrapleural fibrinolytic therapy and DNase, whereas others showed higher treatment escalation rates. In the issue of the Journal, Charron et al. show that RTT, combined with IPFT and DNase, decreases both pleural drainage duration and hospital stay when compared with chest drainage, without increasing mortality, surgical referral, or complication rates. However, methodological concerns, including variability in pleural infection definition, retrospective design, and centre-dependent treatment strategies, might limit the generalizability. Large-scale randomized controlled trials are needed to definitively establish its role.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"16"},"PeriodicalIF":8.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory dysbiosis as prognostic biomarker of disease severity for adults with community-acquired pneumonia requiring mechanical ventilation.","authors":"Loreto Vidaur, Amalur Guridi, Oihana Leizaola, Jokin Marin, Jordi Rello, Cristina Sarasqueta, Ane Sorarrain, Jose María Marimón","doi":"10.1186/s41479-025-00163-1","DOIUrl":"https://doi.org/10.1186/s41479-025-00163-1","url":null,"abstract":"<p><strong>Objetives: </strong>To ascertain the role of the lung microbiome in the development of severe pneumonia and its potential as a biomarker for disease progression.</p><p><strong>Methods: </strong>BAL samples from 34 adults with severe community-acquired pneumonia (CAP) (17 viral, 8 viral coinfected with bacteria and 9 bacterial) admitted to the ICU for acute respiratory failure between 2019 and 2021 were collected within the first 48 h of admission to the ICU. The microbiome was characterized via the Ion 16S Metagenomics Kit and the Ion Torrent sequencing platform. Clinical factors, including survival, mechanical ventilation duration, blood biomarkers and organ failure in terms of acute respiratory distress syndrome (ARDS), shock or acute renal failure, were correlated with microbiome characteristics.</p><p><strong>Results: </strong>The microbiome diversity in patients with viral pneumonia was significantly greater than that in patients with bacterial or coinfected pneumonia: the Shannon diversity index was 3.75 (Q1-Q3: 2.5-4.1) versus 0.4 (Q1-Q3: 0.2-1.3) and 0.48 (Q1-Q3: 0.3-1.1), respectively (p < 0.05). The microbiome diversity index was associated with severity-of-illness (APACHE II), independent of the etiology of pneumonia (B coefficient -1.845; p < 0.01). Patients with severe viral CAP who developed ARDS had a lower presence of Proteobacteria, and those who were complicated with ventilator-associated pneumonia had a higher prevalence of Acinetobacter at admission. The mortality of patients with bacterial or coinfected pneumonia was 35%. In coinfected patients, the diversity index was associated with the development of shock.</p><p><strong>Conclusion: </strong>Patients with severe CAP have low respiratory microbiome diversity, indicating that respiratory microbiome diversity is a potential biomarker of disease severity.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"10"},"PeriodicalIF":8.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the incidence, viral coinfection pattern and outcomes of pneumococcal hospitalizations during and after the COVID-19 pandemic.","authors":"King-Pui Florence Chan, Ting-Fung Ma, Hanshu Fang, Wai-Kai Tsui, James Chung-Man Ho, Mary Sau-Man Ip, Pak-Leung Ho","doi":"10.1186/s41479-025-00164-0","DOIUrl":"https://doi.org/10.1186/s41479-025-00164-0","url":null,"abstract":"<p><strong>Background: </strong>The incidence of pneumococcal pneumonia in the context of the Coronavirus Disease 2019 (COVID-19) pandemic, along with the real-world data on the ratio of non-invasive to invasive pneumococcal pneumonia, is an area that has not been thoroughly studied. The outcomes associated with coinfection of influenza and COVID-19 remain unknown. This study examined the incidence, demographics, coinfection with influenza and/or COVID-19, and clinical outcomes of pneumococcal hospitalizations in Hong Kong during the baseline, pandemic, and post-pandemic periods.</p><p><strong>Methods: </strong>Hospitalization records of individuals aged 18 years and above with pneumococcal disease from January 2015 to August 2024 were extracted from the territory-wide electronic medical record database. Pneumococcal disease was categorized into invasive pneumococcal pneumonia (IPP), invasive pneumococcal disease without pneumonia (IPDWP), and non-invasive pneumococcal pneumonia (NIPP), followed by univariate and multivariate analyses. Effects of coinfection with influenza and COVID-19 were analyzed.</p><p><strong>Results: </strong>The incidence of pneumococcal disease decreased during the COVID-19 pandemic but rebounded in the post-pandemic period. There were no significant changes in the distribution of pneumococcal serotypes across the three periods. The study revealed a strong positive correlation between monthly pneumococcal hospitalizations and the indicator of influenza activity, while the correlation with the COVID-19 indicator was weak. Additionally, strong positive correlations were observed between the indicator of influenza activity and influenza coinfections, as well as between the indicator of COVID-19 activity and COVID-19 coinfections. Multivariate analyses identified male gender, a higher comorbidity index, older age, invasive pneumococcal disease (IPP and IPDWP), coinfection with influenza and COVID-19, and hospitalization during the pandemic period as factors associated with adverse outcomes.</p><p><strong>Conclusions: </strong>The study showcases changes in the epidemiology of pneumococcal disease during and after the COVID-19 pandemic. It highlights the adverse effects of influenza and COVID-19 coinfections on the outcomes of patients with pneumococcal disease and emphasizes the need to vaccinate vulnerable populations against these infections.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"9"},"PeriodicalIF":8.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of respiratory syncytial virus disease across the lifespan in Italy.","authors":"Paolo Manzoni, Eugenio Baraldi, Irene Cetin, Stefania Maggi, Matteo Riccò, Roberta Siliquini, Giovanni Sotgiu, Elsa Viora","doi":"10.1186/s41479-025-00160-4","DOIUrl":"10.1186/s41479-025-00160-4","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) causes substantial morbidity and mortality across the lifespan, with the highest burden seen in infants and older adults. Recently approved immunizing agents, including long-acting neutralizing monoclonal antibodies and a maternal vaccine for passive immunization of newborns, and three vaccines for adults aged 60 years and older who are vulnerable to RSV disease, have the potential to prevent severe RSV-associated disease if implemented successfully. The use of these agents will be implemented in some Italian regions over the next few months, although no consistent timelines or decisions for adoption at the national level are expected. A multidisciplinary group of experts in neonatology, obstetrics and gynecology, respiratory medicine, geriatric medicine, hygiene, and public health reviewed the evidence on RSV prevention and present here their considerations on implementing an RSV prevention strategy in Italy. Given the associated disease burden, it is essential to move quickly to deploy these agents in vulnerable populations, enhance surveillance to accurately detect/predict seasonal trends in RSV activity and measure the impact of prevention strategies. Continuing research combined with widespread use of more sensitive testing is needed to identify vulnerable populations and risk factors. Policies are needed to support these preventive measures in the Italian healthcare system, and access must be accompanied by educational initiatives and advocacy to promote acceptance by HCPs and the target population.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"8"},"PeriodicalIF":8.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptococcus pneumoniae serotype 33H: a novel serotype with frameshift mutations in the acetyltransferase gene wciG.","authors":"Sam Manna, Belinda D Ortika, Joel P Werren, Casey L Pell, Ilche Gjuroski, Stephanie W Lo, Jason Hinds, Odgerel Tundev, Eileen M Dunne, Bradford D Gessner, Fiona M Russell, E Kim Mulholland, Tuya Mungun, Claire von Mollendorf, Stephen D Bentley, Markus Hilty, Neil Ravenscroft, Catherine Satzke","doi":"10.1186/s41479-025-00162-2","DOIUrl":"10.1186/s41479-025-00162-2","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus pneumoniae (the pneumococcus) is a leading cause of community-acquired pneumonia. Pneumococci are categorised into serotypes, based on the type of capsular polysaccharide produced, which has important implications for virulence, vaccine impact and global surveillance. Recently, we identified a novel serotype, which we named 33G, that is comprised of an O-acetylated hexasaccharide repeat unit. In this study, we report and describe variants of 33G, designated 33G-like, which we isolated from the nasopharynx of two adults hospitalised with pneumonia in Mongolia.</p><p><strong>Methods: </strong>Serological comparison of 33G and 33G-like pneumococci were conducted by Quellung serotyping. Genetic analysis of the capsular polysaccharide loci was performed using whole genome sequencing. Polysaccharide composition was determined using ¹H nuclear magnetic resonance.</p><p><strong>Results: </strong>By Quellung serotyping, 33G pneumococci type as both 10B and 33B whereas 33G-like pneumococci type as both 10B and 33F. Genomic analysis of the capsular polysaccharide locus revealed 33G-like loci are identical to 33G, except for frameshift mutations in the wciG gene which encodes an acetyltransferase responsible for the O-acetylation of beta-galactofuranose (β-Galf) in the capsular polysaccharide repeat unit. We constructed an artificial 33G-like by deleting wciG in a 33G strain and confirmed this gene was responsible for the serological differences between 33G and 33G-like pneumococci. Lastly, ¹H nuclear magnetic resonance confirmed the O-acetylation present in the 33G polysaccharide is absent in the 33G-like polysaccharide.</p><p><strong>Conclusions: </strong>Here, we have provided serological, genetic and biochemical evidence that the 33G-like capsule differs to 33G and all other pneumococcal serotypes, meeting the requirements to be designated as a new serotype, which we have named 33H.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"7"},"PeriodicalIF":8.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High incidence of pneumonia cases observed in children seen in general practice consultations during the 2023-2024 season, France.","authors":"Caroline Guerrisi, Olivier Steichen, Titouan Launay, Isabelle Bardoulat, Delphine Viriot, Mathilde François, Aubane Renard, Josselin Le Bel, Louise Rossignol, Romain Palich, François Goehringer, Alexandre Bleibtreu, Isabelle Parent du Châtelet, Thomas Hanslik, Thierry Blanchon","doi":"10.1186/s41479-025-00159-x","DOIUrl":"10.1186/s41479-025-00159-x","url":null,"abstract":"<p><strong>Background: </strong>An increase in hospitalizations for respiratory illnesses due to Mycoplasma pneumoniae was reported in France in late October 2023. Data in primary care are scarce and microbiological or radiological investigations are not routinely recommended for community-acquired pneumonia.</p><p><strong>Methods: </strong>We computed weekly incidence rates of pneumonia and bronchiolitis cases from the electronic records of French general practitioners from January 2016 to August 2024. These weekly incidences were described in the light of the Covid-19 pandemic, overall and by age group. For better interpretation, the weekly incidences of pneumonia and bronchiolitis were compared with virological surveillance data of acute respiratory infections observed in general practice.</p><p><strong>Results: </strong>During the 2016-2024 period, 108,539 cases of pneumonia and 46,411 cases of bronchiolitis were identified from 51,351,414 consultations. The incidence of pneumonia consultations in general practice during the 2022-2023 and 2023-2024 seasons is similar to that observed before the Covid-19 pandemic, after two seasons of low incidence (2020-2021 and 2021-2022). However, the 2023-2024 pneumonia epidemic is the strongest ever observed in children (0-14 years, and especially among the 5-14 years) in general practice since 2016, with an earlier onset. Regarding the incidence of bronchiolitis in children, the 2023-2024 season was in line with the 2021-2022, 2022-2023 and pre-pandemic seasons. No abnormal circulation of classical seasonal viruses was observed during the 2023-2024 season.</p><p><strong>Conclusions: </strong>The sharp increase in pneumonia cases observed this season among children in primary care settings requires the implementation of studies to understand the cause and to confirm or refute the possible association with M. pneumoniae as observed in hospitals. Given the impact of the Covid-19 pandemic on the circulation of pathogens, it would be useful to extend, even on a temporary basis, the traditional microbiological surveillance in primary care to include common bacterial pathogens affecting the upper and lower respiratory tract, such as M. pneumoniae, S. pneumoniae or Streptococcus A.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"6"},"PeriodicalIF":8.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Radiographically confirmed pneumonia in Malawian children and associated Pneumococcal carriage after introduction of the 13-valent Pneumococcal conjugate vaccine.","authors":"Grace Mzumara, James Chirombo, Todd D Swarthout, Naor Bar-Zeev, Philliness Prisca Harawa, Mohamed Sanusi Jalloh, Amir Kirolos, Victoria Mukhula, Laura Newberry, Olawale Ogunlade, Richard Wachepa, Neil French, Robert S Heyderman, Pui-Ying Iroh Tam","doi":"10.1186/s41479-025-00161-3","DOIUrl":"10.1186/s41479-025-00161-3","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"11"},"PeriodicalIF":8.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescent antibody-based detection and ultrastructural analysis of Streptococcus pneumoniae in human sputum.","authors":"Ana G Jop Vidal, Meg Francis, Maneesha Chitanvis, Kenichi Takeshita, Ithiel J Frame, Poonam Sharma, Patricio Vidal, Claudio F Lanata, Carlos Grijalva, William Daley, Jorge E Vidal","doi":"10.1186/s41479-025-00157-z","DOIUrl":"10.1186/s41479-025-00157-z","url":null,"abstract":"<p><strong>Background: </strong>Pneumococcal pneumonia continues to be a significant global health burden, affecting both children and adults. Traditional diagnostic methods for sputum analysis remain challenging. The objective of this study was twofold: to develop a rapid and easy-to-perform assay for the identification of Streptococcus pneumoniae (Spn) directly in sputum specimens using fluorescence microscopy, and to characterize with high-resolution confocal microscopy the ultrastructure of pneumococci residing in human sputum.</p><p><strong>Methods: </strong>We fluorescently labeled antibodies against the pneumococcal capsule (Spn-FLUO). The specificity and sensitivity of Spn-FLUO for detecting Spn was evaluated in vitro and in vivo using mouse models of carriage and disease, human nasopharyngeal specimens, and sputum from patients with pneumococcal pneumonia. Spn was confirmed in the specimens using culture and a species-specific qPCR assay. Spn strains were serotyped by Quellung. Confocal microscopy and Imaris software analysis were utilized to resolve the ultrastructure of pneumococci in human sputum.</p><p><strong>Results: </strong>Compared with cultures and qPCR, Spn-FLUO demonstrated high sensitivity (78-96%) in nasopharyngeal samples from mice and humans. The limit of detection (LOD) in nasopharyngeal samples was ≥ 1.6 × 10⁴ GenEq/ml. The specificity in human nasopharyngeal specimens was 100%. In lung specimens from mice infected with pneumococci, Spn-FLUO reached 100% sensitivity with a LOD of ≥ 1.39 × 10⁴ GenEq/ml. In human sputum, the sensitivity for detecting Spn was 92.7% with a LOD of 3.6 × 10³ GenEq/ml. Ultrastructural studies revealed that pneumococci are expectorated as large aggregates with a median size of 1336 μm².</p><p><strong>Conclusions: </strong>Spn-FLUO is a rapid and sensitive assay for detecting Spn in human sputum within 30 min, encompassing a range of both vaccine and non-vaccine serotypes associated with pneumococcal pneumonia. The study highlights that most pneumococci form aggregates in human sputum.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"17 1","pages":"4"},"PeriodicalIF":8.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}