2301. Streptococcus pneumoniae Serotyping: Assessing the Performance of a PCR- and Sequencing-Based Testing Algorithm

Abstract

Background Streptococcus pneumoniae is a bacterium that causes significant morbidity and mortality worldwide. Its capsular polysaccharides have been used successfully as vaccine antigens, and to characterize S. pneumoniae into 92 different serotypes. Phenotypic (Quellung reaction) or genotopic (PCR or sequencing) methods can be used for serotype assignment, but the performance may vary between methods. This study compared the performance of the Quellung reaction, to an algorithm using PCR- and sequence-based serotyping technologies for vaccine-preventable or closely related serotypes.MethodsA panel of geographically diverse isolates of S. pneumoniae spanning 92 different serotypes was provided by various references laboratories worldwide. Each isolate was subjected to conventional multiplex PCR methods, using previously established methods. Sanger sequencing was performed using genetic signatures defined in the PneumoCaT database. When discrepant, Quellung reaction were repeated, and next-generation sequencing and comparative genomics was used to evaluate the sequence composition of the cps loci.ResultsAs expected, PCR was unable to assign serotype in some cases, and some serotype results were insufficiently discriminatory. Following sequencing, 86.3% (404/468) of isolates were concordant with the Quellung serotyping. Discrepant analyses are underway.ConclusionAn algorithm based on PCR and sequencing, or next-generation sequencing alone, shows much promise for serotyping of S. pneumoniae. However, discrepant results were noted, suggesting either our current understanding of genetic signatures conferring serotype-specificity might not be complete, or the Quellung reaction results were incorrect. Accurate methods for serotyping are essential to monitor the impact of pneumococcal vaccines, and understand the epidemiology of S. pneumoniae diseases.Disclosures S. A. McNeil, GSK: Grant Investigator, Research grant. Pfizer: Grant Investigator, Research grant. Merck: Collaborator and Consultant, Contract clinical trials and Speaker honorarium. Novartis: Collaborator, Contract clinical trials. Sanofi Pasteur: Collaborator, Contract clinical trials.