The utility of the polymerase chain reaction assay for aetiologic definition of unspecified bacterial meningitis cases

Memórias do Instituto Oswaldo Cruz

Mari Tuyama²  Renata F Boente²  Maria C Rebelo¹  Ricardo P Igreja¹  David E Barroso² 

[1] ,Fiocruz Instituto Oswaldo Cruz Grupo de Doenças Virais, Rickettsioses e Febres HemorrágicasRio de Janeiro RJ ,Brasil

关键词: meningitis;    PCR;    Streptococcus pneumoniae;    Neisseria meningitidis;    Haemophilus influenzae;    cerebrospinal fluid;   

DOI  :  10.1590/S0074-02762008000200003

来源: SciELO

【 摘 要 】

Most patients with acute suppurative meningitis are otherwise healthy individuals with regard to immune mechanisms against invasive bacterial disease. This medical emergency is among the most dramatic and potentially ravaging diseases that affect humans, particularly young children. The illness often strikes suddenly, and can either result in death or leave the survivors with significant neurological dysfunctions. The demonstration of a bacterial aetiology is necessary for decisions regarding treatment and prophylaxis. Conventional bacteriological methods frequently fail to identify an agent, as a result of administration of antibiotics or delayed lumbar punctures. We investigated the major aetiologic sources of unspecified bacterial meningitis cases (G00.9, ISCD-10) by polymerase chain reaction (PCR)-based identification of Neisseria meningitidis (crgA), Streptococcus pneumoniae (ply) and Haemophilus influenzae (bexA) in cerebrospinal fluid samples. The multiplex PCR detected N. meningitidis in 92%, S. pneumoniae in 4% and H. influenzae in 1% of the 192 clinical samples assayed; 3% were negative for all three DNA targets. Bacterial DNA detection was found to be a valuable adjunct to enhance bacterial meningitis surveillance when the yield of specimens by culture is reduced. The implementation of PCR assays as a diagnostic procedure in Public Health Laboratories is perceived to be a significant advance in the investigation of bacterial meningitis.

【 授权许可】

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