Catherine SatzkeEileen M. DunneBarbara D. PorterKeith P. KlugmanE. Kim MulhollandJorge E. VidalFuminori SakaiJanet E. StrachanDeborah C. Hay BurgessDouglas HoltzmanK. BoelsenMaha HabibJayne ManningBelinda D. OrtikaCasey L. PellJenna A. SmythMartin AntonioKeith P. KlugmanKatherine L. O’BrienRoy M. Robins-BrowneJ. Anthony ScottSamir K. SahaFiona M. RussellAndrew R. GreenhillDeborah LehmannPeter V. AdrianShabir A. MadhiLorry G. RubinAtqia RizviJason HindsKatherine A. GouldFanrong KongShahin OftadehGwendolyn L. GilbertLu FengBoyang CaoGláucia Paranhos-BaccalàJean Noel TellesMélina MessaoudiRay BorrowElaine StanfordRobert GeorgeCarmen SheppardSilvio D. BruggerKathrin MühlemannMarkus HiltyIsmar A. Rivera-OliveroJacobus H. de WaardBambos M. CharalambousMarcus H. LeungChiara AzzariMaria MoriondoFrancesco NiedduPeter W.M. HermansChrista E. van der Gaast-de JonghPaul TurnerDavid J. EckerRangarajan SampathRoyal Children's Hospital, MelbourneUniversity of MelbourneRollins School of Public HealthLondon School of Hygiene & Tropical MedicineBill and Melinda Gates FoundationKimataifa Diagnostics & Devices ConsultingTakeda VaccinesMurdoch Children's Research InstituteVaccinology ThemeJohns Hopkins Bloomberg School of Public HealthKenya Medical Research InstituteDhaka Shishu HospitalPapua New Guinea Institute of Medical ResearchFederation University AustraliaTelethon Kids InstituteUniversity of WitwatersrandChildren's Medical CenterUniversity of LondonWestmead HospitalThe University of SydneyNankai UniversityPublic Health EnglandStatens Serum InstitutUniversity of BernThe Forsyth InstituteHarvard School of Dental MedicineUniversitatsSpital BernUniversidad Central de VenezuelaUCLCity University of Hong KongUniversita degli Studi di FirenzeRadboud University Nijmegen Medical CentreMahidol UniversityAngkor Hospital for ChildrenUniversity of Oxford2018-11-232018-11-232015-11-01PLoS Medicine. Vol.12, No.11 (2015)15491676154912772-s2.0-85000501013https://repository.li.mahidol.ac.th/handle/20.500.14594/36279© 2015 Satzke et al. Background: The pneumococcus is a diverse pathogen whose primary niche is the nasopharynx. Over 90 different serotypes exist, and nasopharyngeal carriage of multiple serotypes is common. Understanding pneumococcal carriage is essential for evaluating the impact of pneumococcal vaccines. Traditional serotyping methods are cumbersome and insufficient for detecting multiple serotype carriage, and there are few data comparing the new methods that have been developed over the past decade. We established the PneuCarriage project, a large, international multi-centre study dedicated to the identification of the best pneumococcal serotyping methods for carriage studies. Methods and Findings: Reference sample sets were distributed to 15 research groups for blinded testing. Twenty pneumococcal serotyping methods were used to test 81 laboratory-prepared (spiked) samples. The five top-performing methods were used to test 260 nasopharyngeal (field) samples collected from children in six high-burden countries. Sensitivity and positive predictive value (PPV) were determined for the test methods and the reference method (traditional serotyping of >100 colonies from each sample). For the alternate serotyping methods, the overall sensitivity ranged from 1% to 99% (reference method 98%), and PPV from 8% to 100% (reference method 100%), when testing the spiked samples. Fifteen methods had ≥70% sensitivity to detect the dominant (major) serotype, whilst only eight methods had ≥70% sensitivity to detect minor serotypes. For the field samples, the overall sensitivity ranged from 74.2% to 95.8% (reference method 93.8%), and PPV from 82.2% to 96.4% (reference method 99.6%). The microarray had the highest sensitivity (95.8%) and high PPV (93.7%). The major limitation of this study is that not all of the available alternative serotyping methods were included. Conclusions: Most methods were able to detect the dominant serotype in a sample, but many performed poorly in detecting the minor serotype populations. Microarray with a culture amplification step was the top-performing method. Results from this comprehensive evaluation will inform future vaccine evaluation and impact studies, particularly in low-income settings, where pneumococcal disease burden remains high.Mahidol UniversityMedicineArticleSCOPUS10.1371/journal.pmed.1001903