Polymerase chain reaction for diagnosis of meningococcal meningitis

• Published in: The Lancet (British edition) Vol. 340; no. 8833; pp. 1432 - 1434
• Main Authors: Ni, H., Knight, A.I., McFadden, J., Cartwright, K., Palmer, W.H.
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 12.12.1992; Lancet; Elsevier Limited
• Subjects: Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; DNA, Bacterial - analysis; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical research; Medical sciences; Meningitis, Meningococcal - cerebrospinal fluid; Meningitis, Meningococcal - diagnosis; Neisseria meningitidis - isolation & purification; Neurological disorders; Polymerase Chain Reaction; Sensitivity and Specificity; Tests; Infection; Human; Polymerase chain reaction; Nervous system diseases; Bacteriosis; Diagnosis; Cerebrospinal fluid; Meningococcal disease
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(92)92622-M

Meningococcal disease is normally suspected on clinical grounds but confirmed by isolation of Neisseria meningitidis from blood or cerebrospinal fluid (CSF), or by detection of gram-negative diplococci in CSF. After parenteral antibiotics are started the isolation rate of meningococci from blood cultures drops from 50% to less than 5% and the chances of CSF being positive by culture or microscopy are also reduced. We used the polymerase chain reaction (PCR) in a blinded study to detect meningococcal DNA in 54 CSF samples from patients with meningococcal disease or from controls. The PCR primers were specific for the meningococcal insertion sequence IS 1106. The sensitivity and specificity of this PCR for diagnosis of meningococcal meningitis were both 91%. Sensitivity was not affected by prior antibiotic treatment. The IS 1106 PCR is a rapid and sensitive test for confirmation of the diagnosis of meningococcal meningitis.