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Streptococcus pneumoniae is a significant cause of respiratory illness in older adults and colonization is considered a necessary precursor to invasive disease. Carriage studies may provide insights about the effects of vaccination in adults if cumulative incidence can be shown to be higher that previously demonstrated by earlier studies using traditional bacterial culture methods. The lytA PCR assay developed by the Center for Disease Control (CDC) has been used to screen samples and is felt to be sensitive and specific for S. pneumoniae. However, unless pneumococcal isolates are recovered from lytA + samples, there is a theoretical concern that results reflect Streptococcus mitis/oralis carrying homolog genes. As part of an ongoing longitudinal surveillance study in older adults assessing cumulative incidence of colonization, we assessed lytA + samples for the presence of S. pneumoniae versus lytA + Streptococcus mitis/oralis.

LytA-Positive Streptococcus mitis/oralis Confound Interpretation of Pneumococcal Colonization Studies