title: Real-time qPCR improves meningitis pathogen detection in invasive bacterial-vaccine preventable disease surveillance in Fiji.
abstract: As part of the World Health Organization Invasive Bacterial-Vaccine Preventable Diseases (IB-VPD) surveillance in Suva, Fiji, cerebrospinal fluid (CSF) samples from suspected meningitis patients of all ages were examined by traditional methods (culture, Gram stain, and latex agglutination for bacterial antigen) and qPCR for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Of 266 samples tested, pathogens were identified in 47 (17.7%). S. pneumoniae was the most common pathogen detected (n = 17) followed by N. meningitidis (n = 13). The use of qPCR significantly increased detection of IB-VPD pathogens (P = 0.0001): of 35 samples that were qPCR positive for S. pneumoniae, N. meningitidis, and H. influenzae, only 10 were culture positive. This was particularly relevant for N. meningitidis, as only 1/13 cases was culture positive. Molecular serotyping by microarray was used to determine pneumococcal serotypes from 9 of 16 (56%) of samples using DNA directly extracted from CSF specimens. Results indicate that qPCR significantly increases detection of S. pneumoniae, N. meningitidis, and H. influenzae in CSF, and that application of molecular diagnostics is a feasible way to enhance local and global surveillance for IB-VPD.
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Dunne
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Silivia
authors.initials: S
authors.lastname: Mantanitobua
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Shalini P
authors.initials: SP
authors.lastname: Singh
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.
authors.forename: Rita
authors.initials: R
authors.lastname: Reyburn
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Tuivaga
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Eric
authors.initials: E
authors.lastname: Rafai
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Lisi
authors.initials: L
authors.lastname: Tikoduadua
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Porter
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.|The University of Melbourne, Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, Australia.|The University of Melbourne, Department of Paediatrics, Parkville, 3052, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Satzke
authors.affiliation: The University of Melbourne, Microbiological Diagnostic Unit Public Health Laboratory, Melbourne, 3000, Australia.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Strachan
authors.affiliation: World Health Organization Regional Office for the Western Pacific, Manila, Philippines.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Fox
authors.affiliation: Fiji Health Sector Support Program, Suva, Fiji.
authors.forename: Kylie M
authors.initials: KM
authors.lastname: Jenkins
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.|Fiji National University, Department of Medical Science, College of Medicine, Nursing and Health Sciences, Suva, Fiji.
authors.forename: Adam
authors.initials: A
authors.lastname: Jenney
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Silo
authors.initials: S
authors.lastname: Baro
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.|London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, WC1E 7HT, UK.
authors.forename: E Kim
authors.initials: EK
authors.lastname: Mulholland
authors.affiliation: Ministry of Health &Medical Services, Suva, Fiji.
authors.forename: Mike
authors.initials: M
authors.lastname: Kama
authors.affiliation: Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.|The University of Melbourne, Department of Paediatrics, Parkville, 3052, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D000328:Adult; D001428:Bacterial Vaccines / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005367:Fiji; D006193:Haemophilus influenzae / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000235:genetics / Q000382:microbiology / Q000517:prevention & control; D009345:Neisseria meningitidis / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D013296:Streptococcus pneumoniae / Q000235:genetics*
chemical_list: D001428:Bacterial Vaccines