MOLECULAR DETECTION OF STREPTOCOCCUS PNEUMONIAE IN PATIENTS WITH PNEUMONIA IN DIWANIYAH CITY
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Objective: Streptococcus pneumoniae is one of the major causative agents of pneumonia in the world. Toll-like receptor 4 (TLR-4) is essential to the innate immune response because it recognizes molecular patterns linked to pathogens. The study's goal was to identify the diagnostic and prognostic TLR-4 level in pneumonia patients and categorize them according to whether or not S. pneumoniae was present infection through the use of molecular detection (PCR). Materials and Methods: The total number of sample subjects was 100 and they were separated into three groups: patients with S. pneumoniae pneumonia (G1), non-S. pneumoniae pneumonia (G2), and a healthy control group. TLR-4 levels were measured, and PCR-based detection was performed on Genomic DNA extracted from blood samples. The statistical tests included multiple range comparisons, Duncan analysis, and independent T-tests. Results: The mean levels of TLR-4 were significantly higher in both pneumonia groups (G1: 483.19 ± 45.7; G2: 561.05 ± 52.7) compared to the healthy control group (265.17 ± 12.5) (P < 0.05). No significant difference was observed between the two pneumonia groups. ROC analysis revealed that TLR-4 has excellent diagnostic accuracy. For pneumonia with S. pneumoniae, the optimal cutoff value was 336.04 (AUC = 0.880), sensitivity = 87.2%, and specificity = 87.5%. For non-S. pneumoniae pneumonia, AUC = 0.912 at cutoff 378.48. TLR-4 levels did not significantly differ between males (518.90 ± 41.8) and females (504.81 ± 33.9) (P = 0.794). Novelty: TLR-4 is a strong biomarker in the clinical diagnosis of pneumonia, effectively distinguishing patients from healthy individuals, but not differentiating pneumococcal and non-pneumococcal etiologies due to its high sensitivity and specificity.
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