Article
Assessment of a two-step nucleic acid amplification assay for detection of Neisseria meningitidis followed by capsular genogrouping
Registro en:
REBELO, Maria C. et al. Assessment of a two-step nucleic acid amplification assay for detection of Neisseria meningitidis followed by capsular genogrouping. Memórias do Instituto Oswaldo Cruz, Rio de Janeiro, v. 101, n. 7, p. 809-813, Nov. 2006.
0074-0206
10.1590/S0074-02762006000700017
1678-8060
Autor
Rebelo, Maria C.
Boente, Renata F.
Matos, Juliana de A.
Hofer, Cristina B.
Barroso, David E.
Resumen
Immediate prevention of meningococcal disease relies in part on the prompt treatment with antibiotics of
household and other close contacts of cases; however intervention with effective vaccination relies on identification
of serogroup-causing strains. Parenteral antibiotic for patient with suspected meningococcal disease
before hospital admission is currently recommended. Laboratory standard methods are hindered by failure to
detect bacteria by this medical approach to improve patient prognosis. We assessed two polymerase chain reaction
(PCR) assays to detect (crgA) and define the serogroups (siaD, orf-2, and ctrA) of Neisseria meningitidis in 120
cerebrospinal fluid (CSF) samples from positive cases (culture or antigen detection or direct smear). The PCR
sensitivity for the identification of N. meningitidis was 100% (95% confidence interval, CI, 96-100%) compared
to a sensitivity of 46% for culture (95% CI 37-55%), 61% for latex agglutination test (95% CI 52-70%), and 68%
for Gram stain (95% CI 59-76%); PCR specificity was 97% (95% CI 82-100%). PCR correctly identified the
serogroups A, B, C, W135, Y, and X in CSF samples with a sensitivity of 88% (95% CI 80-93%); the primer sets
were 100% specific. The introduction of PCR-based assays shall increase laboratory confirmed cases,
consequently enhancing surveillance of meningococcal disease.