Four clinical detection methods and effect assessments of Streptococcus pneumoniae in children with lower respiratory tract infections

OBJECTIVE To compare the accuracy and the consistency of different methods, including nucleic acid assay, biochemical identification, mass spectrometry and targeted next-generation sequencing (tNGs), in detection of Streptococcus pneumoniae for the children with lower respiratory tract infections so as to provide bases for selection of appropriate detection method.

METHODS A total of 120 children with lower respiratory tract infections who were treated in Yibin First People′s Hospital from Aug. 2024 to Mar. 2025 were included in the clinical research. The bronchoalveolar lavage fluid (BALF) specimens were collected from all of the children, which were tested by the nucleic acid testing, biochemical identification, mass spectrometry and tNGS respectively. With tNGS as the gold standard, the consistency of the detection methods was evaluated by Kappa consistency test; meanwhile, the sensitivity, specificity and positive predictive value of the detection methods were observed, and the diagnostic efficiency was compared among the detection methods.

RESULTS The sensitivity, specificity and total accurate rate of tNGS were all higher than those of other three detection methods with significant differences (P < 0.05). The Kappa values of tNGS with the nucleic assay, biochemical identification and mass spectrometry were 0.713, 0.638 and 0.823, respectively, showing high consistencies, especially the consistency with mass spectrometry was relative high.

CONCLUSION tNGS shows higher accuracy in detection of S. pneumoniae and favorable consistency in diagnosis, and it is superior to the traditional biochemical identification and mass spectrometry, with high clinical application value.