Diagnosis of meningococcal meningitis in Brazil by use of PCR.
Fever and a petechial rash are strongly associated with meningococcal disease in the city of Rio de Janeiro. Early antibiotic therapy is indicated and, consequently, a reduction of confirmed cases by culture, Gram stain, and latex agglutination test is expected. We evaluated a multiplex PCR assay to identify Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae in biological samples from cases of non-culture proven meningitis with a petechial rash at presentation. To detect DNA in cerebrospinal fluid (n = 71) or blood (n = 5), a PCR screen was performed, based on the crgA, ply and bexA targets, respectively. Of the total, 70 CSF and 3 blood samples (96%) were positive by PCR for the presence of N. meningitidis DNA. Another PCR assay predicted in 82% of these samples N. meningitidis serogroups A (2%), B (60%), C (7%), X (3%), Y (2%), 29E (2%) or W135 (24%). In non-culture proven meningitis, PCR was found to be a valuable adjunct for the demonstration of meningococcal aetiology.
Pedro
Luciana G F
LG
Department of Bacteriology, Oswaldo Cruz Institute, Rio de Janeiro, FIOCRUZ, Brazil.
Boente
Renata F
RF
Madureira
Danielle J
DJ
Matos
Juliana A
JA
Rebelo
Cristina M
CM
Igreja
Ricardo P
RP
Barroso
David E
DE
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006193:Haemophilus influenzae / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid* / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000235:genetics; D016133:Polymerase Chain Reaction / Q000379:methods*; D012703:Serotyping / Q000379:methods; D013296:Streptococcus pneumoniae / Q000235:genetics
D004269:DNA, Bacterial