Potential application of MALDI-TOF MS to identify Streptococcus parapneumoniae, an emerging pathogen previously misidentified as Streptococcus pneumoniae
Abstract
OBJECTIVES: Accurate identification of Streptococcus species is critical for clinical management and epidemiology. Misidentification of Streptococcus parapneumoniae as Streptococcus pneumoniae can hinder diagnosis and affect treatment outcomes.
METHODS: From 385 archived S. pneumoniae isolates, species-specific polymerase chain reaction (PCR) was used to identify potential S. parapneumoniae. Confirmatory species determination, virulence, and antimicrobial resistance profile analyses were performed through whole-genome sequencing (WGS), phylogenomic, and comparative genomic analyses. Matrix-associated laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) spectral analysis aimed to identify biomarkers for S. parapneumoniae.
RESULTS: Three S. parapneumoniae strains, representing a novel species first identified in Japan in 2024, were isolated from patients with respiratory infections in Hong Kong. WGS showed >99% average nucleotide identity (ANI) with S. parapneumoniae SP4011T, distinct from S. pneumoniae (<94%). These strains possessed virulence factors similar to S. pneumoniae, suggesting pathogenic potential. All isolates exhibited multidrug and levofloxacin resistance, unlike local S. pneumoniae strains. MALDI-TOF MS identified two peaks (m/z 6,399 and m/z 6,960) unique to S. parapneumoniae.
CONCLUSIONS: The multidrug resistance of S. parapneumoniae complicates antimicrobial resistance surveillance data and empirical treatment accuracy for S.…
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