Diagnosis of bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae using a multiplex real-time PCR technique

• Published in: Brazilian journal of microbiology Vol. 53; no. 4; pp. 1951 - 1958
• Main Authors: Carnalla-Barajas, María Noemí, Soto-Noguerón, Araceli, Martínez-Medina, Lucila, Olvera-Herrera, Maria Elizabeth, Mosqueda-Gómez, Juan Luis, Rodríguez-Cortez, Patricia, Morfin-Otero, Rayo, Rodriguez-Noriega, Eduardo, Luévanos-Velázquez, Antonio, Merlo-Palomera, Mariana, Esparza-Ahumada, Sergio, Márquez-Díaz, Francisco, Alpuche-Aranda, Celia Mercedes, Echaniz-Aviles, Gabriela
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2022; Springer Nature B.V
• Subjects: Adolescent; Adult; Antibiotics; Antiinfectives and antibacterials; Bacteria; Biomedical and Life Sciences; Cerebrospinal fluid; Child; Clinical Microbiology - Research Paper; Deoxyribonucleic acid; Diagnosis; Diagnostic systems; DNA; Food Microbiology; Haemophilus influenzae; Haemophilus influenzae - genetics; Health services; Humans; Laboratories; Life Sciences; Medical Microbiology; Meningitis; Meningitis, Bacterial - diagnosis; Microbial Ecology; Microbial Genetics and Genomics; Microbiology; Mycology; Neisseria meningitidis; Neisseria meningitidis - genetics; Polymerase chain reaction; Public health; Real time; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - genetics; Vaccines; Mexico; Real-time PCR; Bacterial meningitis; Cerebrospinal fluid; Neisseria meningitidis; Haemophilus influenzae; Streptococcus pneumoniae
• ISSN: 1517-8382; 1678-4405
• DOI: 10.1007/s42770-022-00826-x

Bacterial meningitis is one of the diseases that, despite the introduction of several vaccines, remains a serious public health concern. Streptococcus pneumoniae (Spn), Neisseria meningitidis (Nm), and Haemophilus influenzae (Hi) are responsible for most cases diagnosed in children, adolescents, and adult population. Rapid, sensitive, and specific laboratory assays are critical for effective diagnosis and treatment, particularly in countries like Mexico in which culture positivity rates are very low due to the use of antibiotics prior to sample collection and to delay in transporting samples to the laboratory. The aim of this study was to evaluate the use of real-time polymerase chain reaction (RT-PCR) of cerebrospinal fluid (CSF) as a rapid diagnostic test for bacterial meningitis and compare these results with bacterial culture in three general hospitals in Mexico. During a 5-year period (2014–2018), a total of 512 CSF samples obtained from patients in whom infectious meningitis was suspected as initial clinical diagnosis were tested with RT-PCR with species-specific targets for the three pathogens. For Spn, 5.07% samples were RT-PCR positive; 0.39% for Nm and none for Hi. Only five RT-PCR Spn positive samples had a positive culture. Sensitivity and specificity estimates for RT-PCR are 100% and 95.46%, respectively. DNA amplification methods can provide better sensitive diagnostic tests than the reference standard, which is culture, particularly when antimicrobial treatment is initiated before clinical samples can be obtained.