<![CDATA[Streptococcus pneumoniae merupakan patogen utama penyebab pneumonia komunitas pada populasi dewasa, dengan kolonisasi nasofaring sebagai tahap awal patogenesis. Deteksi bakteri ini menggunakan sampel nasopharyngeal swab (NPS) memiliki peran penting dalam diagnosis dan surveilans, namun performa diagnostiknya bervariasi tergantung metode yang digunakan. Literature review ini bertujuan untuk membandingkan metode deteksi S. pneumoniae pada sampel NPS pada populasi dewasa, dengan fokus pada sensitivitas, spesifisitas, dan implikasi klinis. Kajian dilakukan terhadap artikel publikasi tahun 2015–2026 yang melibatkan populasi dewasa (≥18 tahun) dan menggunakan NPS sebagai spesimen utama atau pembanding. Hasil menunjukkan bahwa metode polymerase chain reaction (PCR), khususnya quantitative PCR (qPCR) dengan target gen lytA dan piaB, memiliki sensitivitas lebih tinggi dibandingkan kultur konvensional yang cenderung underestimasi kolonisasi. Namun, sensitivitas NPS pada dewasa tetap terbatas dibandingkan spesimen lain seperti sputum dan orofaring, terutama pada kasus dengan densitas bakteri rendah. Penggunaan multiplex PCR dan panel molekuler meningkatkan diagnostic yield serta memungkinkan deteksi simultan berbagai patogen pernapasan. Selain metode, faktor usia, lokasi kolonisasi, dan jenis sampel turut memengaruhi hasil deteksi. Disimpulkan bahwa PCR merupakan metode yang lebih sensitif dibandingkan kultur dalam deteksi S. pneumoniae pada NPS dewasa, namun keterbatasan biologis NPS perlu dipertimbangkan sehingga kombinasi metode dan sampel dapat meningkatkan akurasi diagnostik. Abstract Streptococcus pneumoniae is a major pathogen responsible for community-acquired pneumonia in adults, with nasopharyngeal colonization representing the initial stage of pathogenesis. Diagnostic detection of this bacterium using nasopharyngeal swab (NPS) specimens plays an important role in clinical diagnosis and surveillance; however, its diagnostic performance varies depending on the method employed. This literature review aimed to compare diagnostic methods for Streptococcus pneumoniae using NPS specimens in adult populations, with a particular focus on sensitivity, specificity, and clinical implications. The review included articles published between 2015 and 2026 involving adult participants (≥18 years) and utilizing NPS as the primary or comparative specimen. The findings indicate that Polymerase Chain Reaction (PCR)-based methods, particularly quantitative PCR (qPCR) targeting the lytA and piaB genes, exhibit higher sensitivity than conventional culture methods, which generally detect lower rates of colonization. Nevertheless, the sensitivity of NPS in adults remains limited compared with other specimen types, such as sputum and oropharyngeal swabs, especially in cases with low bacterial density. The use of multiplex PCR and molecular diagnostic panels enhances diagnostic yield and enables the simultaneous detection of multiple respiratory pathogens. In addition to the diagnostic method, factors such as age, colonization site, and specimen type also influence diagnostic outcomes. In conclusion, PCR is a more sensitive method than conventional culture for the detection of Streptococcus pneumoniae in adult NPS specimens. However, the biological limitations of NPS should be taken into account, and combining diagnostic methods with multiple specimen types may improve overall diagnostic accuracy.]]>
