Quantitative Polymerase Chain Reaction for Improved Detection of Pneumococci in CAP "CAPTAIN"

Inclusion Criteria: Patients: * Age 18 years or above; * Presentation at the emergency department (ED); * Working diagnosis of CAP at the ED with the presence of at least two of the following criteria: 1. New or worsened coughing; 2. Production of purulent sputum or change in sputum colour; 3. Temperature \>38.0 ⁰C or ≤36.0 ⁰C (tympanic); 4. Auscultatory findings consistent with pneumonia, including rales, evidence of pulmonary consolidation (dullness on percussion, bronchial breath sounds, rales, or egophony), or both; 5. White blood cell count of \>10x10\^9 cells/L or \<4x10\^9 cells/L or \>15% bands; 6. C-reactive protein level ≥30mg/L; 7. Dyspnea, tachypnea, (\>20 breaths per minute), or hypoxemia (arterial pO2 \<60mmHg or peripheral O2 saturation \<90%). * New consolidation(s) on the chest radiograph or computed tomography (CT); * No other explanation for the signs and symptoms; Control group 1 - Related controls * Being aged 18 years or above; * Close relative of the patient: relative defined as living in the same house as the CAP patient or daily contact; * Is at the hospital at the moment of inclusion of the CAP patient or is willing to come for testing within 7 days; Control group 2 - Unrelated healthy individuals * Being aged 18 years or above; * Subject with a preoperative appointment with the anaesthiologist for a planned surgical procedure; * Age matched to a included CAP patient (+-10 years); * Time matched to a included CAP patient (up to 14 days after inclusion of the CAP patient); * Gender matched to a included CAP patient. Control group 3 - Patients with stable COPD * Being aged 18 years or above; * Diagnosis of COPD confirmed with spirometry (GOLD criteria 2017)(76); * Stable disease. Control group 4 - Patients with exacerbation of COPD * Being aged 18 years or above; * Diagnosis of COPD confirmed with spirometry (GOLD criteria 2017)(76); * Diagnosis of exacerbation of COPD: defined as an acute event characterised by a worsening of the patient's respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medication (76). * Presentation at emergency department with the suspicion of an exacerbation. Exclusion Criteria: In general: * Recent pneumonia (\< 1 month) or pneumonia in last 3 months with known pneumococcal aetiology with one of current diagnostics; * Was included in the study group before; * Not capable of understanding information needed to sign informed consent. Patients: * Aspiration pneumonia; * Hospitalisation for two or more days in the last 14 days; * History of cystic fibrosis. For all control groups: * Fits inclusion criteria for patient group; * Present or recent hospitalisation (14 days); * Fits inclusion criteria for patient group; * Use of antibiotics in the last 14 days, including maintenance antibiotic therapy. Control group 1 and 2 - Related healthy controls and unrelated healthy individuals * Active infectious respiratory complaints defined as defined as two or more respiratory symptoms (cough, nasal congestion, runny nose, sore throat or sneezes); * Temperature \>38.0 ⁰C; * Fits inclusion criteria for control group 3 or 4; * Chronic pulmonary disease: COPD, asthma, cystic fibrosis, bronchiectasis. Control group 3 - Patients with stable COPD * Temperature \>38.0 ⁰C; * Stable disease; * Fits inclusion criteria for control group 4; * Recent exacerbation (\<1 month) defined as increased respiratory symptoms with need of antibiotic and/or corticosteroid therapy; * History of cystic fibrosis. Control group 4 - Patients with exacerbation of COPD * Current pneumonia; * Recent exacerbation (\<1 month) defined as increased respiratory symptoms with need of antibiotic and/or corticosteroid therapy; * Fits inclusion criteria for control group 3; * History of cystic fibrosis.