title: Real-time PCR for detection of Streptococcus suis serotype 2 in cerebrospinal fluid of human patients with meningitis.
abstract: Streptococcus suis serotype 2 is an emerging zoonotic pathogen and is the main cause of acute bacterial meningitis in adult patients in Vietnam. We developed an internally controlled real-time PCR for detection of S. suis serotype 2 in cerebrospinal fluid (CSF) samples targeted at the cps2J gene. Sensitivity and specificity in culture-confirmed clinical samples were 100%. The PCR detected S. suis serotype 2 infection in 101 of 238 (42.4%) prospectively collected CSF samples, of which 55 (23%) were culture positive. Culture-negative but PCR-positive CSF samples were significantly associated with the use of antimicrobial agents before admission. S. suis serotype 2 infection was more common than infections with Streptococcus pneumoniae and Neisseria meningitidis combined. Our results strikingly illustrate the additional diagnostic value of PCR in patients who are pretreated with antimicrobial agents and demonstrate the extremely high prevalence of S. suis infections among Vietnamese adult patients with bacterial meningitis.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Tran Vu Thieu
authors.initials: TV
authors.lastname: Nga
authors.forename: Ho Dang Trung
authors.initials: HD
authors.lastname: Nghia
authors.forename: Le Thi Phuong
authors.initials: le TP
authors.lastname: Tu
authors.forename: To Song
authors.initials: TS
authors.lastname: Diep
authors.forename: Nguyen Thi Hoang
authors.initials: NT
authors.lastname: Mai
authors.forename: Tran Thi Hong
authors.initials: TT
authors.lastname: Chau
authors.forename: Dinh Xuan
authors.initials: DX
authors.lastname: Sinh
authors.forename: Nguyen Hoan
authors.initials: NH
authors.lastname: Phu
authors.forename: Tran Thi Thu
authors.initials: TT
authors.lastname: Nga
authors.forename: Nguyen Van Vinh
authors.initials: NV
authors.lastname: Chau
authors.forename: James
authors.initials: J
authors.lastname: Campbell
authors.forename: Ngo Thi
authors.initials: NT
authors.lastname: Hoa
authors.forename: Nguyen Tran
authors.initials: NT
authors.lastname: Chinh
authors.forename: Tran Tinh
authors.initials: TT
authors.lastname: Hien
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.forename: Constance
authors.initials: C
authors.lastname: Schultsz
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques / Q000379:methods; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D015995:Prevalence; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D017011:Streptococcus suis / Q000302:isolation & purification*; D014744:Vietnam / Q000453:epidemiology