In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae

Background As a standard method for pneumococcal carriage studies, the World Health Organization recommends nasopharyngeal swabs be transported and stored at cool temperatures in a medium containing skim-milk, tryptone, glucose and glycerol (STGG). An enrichment broth used for transport at room temp...

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Main Authors: Anneke Steens, Natacha Milhano, Ingeborg S. Aaberge, Didrik F. Vestrheim
Format: Article
Language:English
Published: PeerJ Inc. 2016-09-01
Series:PeerJ
Subjects:
Online Access:https://peerj.com/articles/2449.pdf
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author Anneke Steens
Natacha Milhano
Ingeborg S. Aaberge
Didrik F. Vestrheim
author_facet Anneke Steens
Natacha Milhano
Ingeborg S. Aaberge
Didrik F. Vestrheim
author_sort Anneke Steens
collection DOAJ
description Background As a standard method for pneumococcal carriage studies, the World Health Organization recommends nasopharyngeal swabs be transported and stored at cool temperatures in a medium containing skim-milk, tryptone, glucose and glycerol (STGG). An enrichment broth used for transport at room temperature in three carriage studies performed in Norway may have a higher sensitivity than STGG. We therefore compared the media in vitro and in vivo. Methods For the in vitro component, three strains (serotype 4, 19F and 3) were suspended in STGG and enrichment broth. Recovery was compared using latex agglutination, quantification of bacterial loads by real-time PCR of the lytA gene, and counting colonies from incubated plates. For the in vivo comparison, paired swabs were obtained from 100 children and transported in STGG at cool temperatures or in enrichment broth at room temperature. Carriage was identified by latex agglutination and confirmed by Quellung reaction. Results In vitro, the cycle threshold values obtained by PCR did not differ between the two media (p = 0.853) and no clear difference in colony counts was apparent after incubation (p = 0.593). In vivo, pneumococci were recovered in 46% of swabs transported in STGG and 51% of those transported in enrichment broth (Kappa statistic 0.90, p = 0.063). Discussion Overall, no statistical differences in sensitivity were found between STGG and enrichment broth. Nevertheless, some serotype differences were observed and STGG appeared slightly less sensitive than enrichment broth for detection of nasopharyngeal carriage of pneumococci by culturing. We recommend the continued use of STGG for transport and storage of nasopharyngeal swabs in pneumococcal carriage studies for the benefit of comparability between studies and settings, including more resource-limited settings.
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spelling doaj.art-e655834b1ae74ce7be1e008dbb7a7bc62023-12-03T10:26:35ZengPeerJ Inc.PeerJ2167-83592016-09-014e244910.7717/peerj.2449In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniaeAnneke Steens0Natacha Milhano1Ingeborg S. Aaberge2Didrik F. Vestrheim3Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, NorwayInfection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, NorwayInfection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, NorwayInfection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, NorwayBackground As a standard method for pneumococcal carriage studies, the World Health Organization recommends nasopharyngeal swabs be transported and stored at cool temperatures in a medium containing skim-milk, tryptone, glucose and glycerol (STGG). An enrichment broth used for transport at room temperature in three carriage studies performed in Norway may have a higher sensitivity than STGG. We therefore compared the media in vitro and in vivo. Methods For the in vitro component, three strains (serotype 4, 19F and 3) were suspended in STGG and enrichment broth. Recovery was compared using latex agglutination, quantification of bacterial loads by real-time PCR of the lytA gene, and counting colonies from incubated plates. For the in vivo comparison, paired swabs were obtained from 100 children and transported in STGG at cool temperatures or in enrichment broth at room temperature. Carriage was identified by latex agglutination and confirmed by Quellung reaction. Results In vitro, the cycle threshold values obtained by PCR did not differ between the two media (p = 0.853) and no clear difference in colony counts was apparent after incubation (p = 0.593). In vivo, pneumococci were recovered in 46% of swabs transported in STGG and 51% of those transported in enrichment broth (Kappa statistic 0.90, p = 0.063). Discussion Overall, no statistical differences in sensitivity were found between STGG and enrichment broth. Nevertheless, some serotype differences were observed and STGG appeared slightly less sensitive than enrichment broth for detection of nasopharyngeal carriage of pneumococci by culturing. We recommend the continued use of STGG for transport and storage of nasopharyngeal swabs in pneumococcal carriage studies for the benefit of comparability between studies and settings, including more resource-limited settings.https://peerj.com/articles/2449.pdfStreptococcus pneumoniaeNasopharyngeal carriageTransport mediaIn vivo and in vitro comparisonCarriage studyPneumococcus
spellingShingle Anneke Steens
Natacha Milhano
Ingeborg S. Aaberge
Didrik F. Vestrheim
In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
PeerJ
Streptococcus pneumoniae
Nasopharyngeal carriage
Transport media
In vivo and in vitro comparison
Carriage study
Pneumococcus
title In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
title_full In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
title_fullStr In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
title_full_unstemmed In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
title_short In vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of Streptococcus pneumoniae
title_sort in vitro and in vivo comparison of transport media for detecting nasopharyngeal carriage of streptococcus pneumoniae
topic Streptococcus pneumoniae
Nasopharyngeal carriage
Transport media
In vivo and in vitro comparison
Carriage study
Pneumococcus
url https://peerj.com/articles/2449.pdf
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