Diagnosis of Streptococcus pneumoniae meningitis by polymerase chain reaction amplification of the gene for pneumolysin

Memórias do Instituto Oswaldo Cruz

Juliana De A Matos²  Danielle J Madureira²  Maria C Rebelo¹  Cristina B Hofer¹  David E Barroso² 

[1] ,Fiocruz Instituto Oswaldo Cruz Departamento de BacteriologiaRio de Janeiro RJ ,Brasil

关键词: Streptococcus pneumoniae;    meningitis;    polymerase chain reaction;    pneumolysin ply gene;   

DOI  :  10.1590/S0074-02762006000500014

来源: SciELO

【 摘 要 】

Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF). The performance of these methods, especially culture and direct smear, is thwarted by failure to detect bacteria following administration of antimicrobial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or established. Thus an alternative method has become necessary to help clinicians and epidemiologists to management and control of bacterial meningitis. We evaluate the application of a polymerase chain reaction-based (PCR) assay for amplification of pneumolysin gene (ply) to diagnosis of Streptococcus pneumoniae meningitis. The PCR assay sensitivity for CSF was 96% (95% confidence interval, CI, 90-99%) compared to a sensitivity of 59% for culture (95% CI 49-69%), 66% for Gram stain (95% CI 56-74%), and 78% for latex agglutination test (95% CI 69-86%); PCR specificity was 100% (95% CI 83-100%). PCR results were available within 4 h of the start of the assay. This molecular approach proved to be reliable and useful to identify this bacterium compared with other classical laboratory methods for identification of bacterial meningitis pathogens.

【 授权许可】

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