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RESEARCH PRODUCT
Culture and Real-time Polymerase Chain reaction sensitivity in the diagnosis of invasive meningococcal disease: Does culture miss less severe cases?
Silvia RicciSilvia RicciGiuseppe IndolfiFrancesco NiedduFrancesco NiedduAlessandro CasiniElisa De VitisElisa De VitisSara GuiducciSara GuiducciMaria MoriondoMassimo RestiChiara AzzariChiara AzzariG.m. PoggiG.m. Poggisubject
Bacterial DiseasesMale0301 basic medicinePhysiologyAntibioticsCell Culture TechniquesMeningococcal DiseaseNeisseria meningitidisPathology and Laboratory Medicinemedicine.disease_causeNervous SystemSeverity of Illness IndexGastroenterology0302 clinical medicineCerebrospinal fluidAntibioticsInfectious Diseases of the Nervous SystemBiochemistry Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all)Case fatality rateMedicine and Health Sciences030212 general & internal medicineChildFalse Negative ReactionsCerebrospinal FluidMultidisciplinaryAntimicrobialsNeisseria meningitidisQRDrugsBody FluidsBacterial PathogensBloodInfectious DiseasesReal-time polymerase chain reactionNeurologyMedical MicrobiologyChild PreschoolMedicineFemaleAnatomyPathogensNeisseriaMeningitisResearch ArticleDNA Bacterialmedicine.medical_specialtyAdolescentmedicine.drug_classScienceInflammatory Diseases030106 microbiologyMeningitis MeningococcalReal-Time Polymerase Chain ReactionMeningococcal diseaseMicrobiologySensitivity and SpecificitySepsisYoung Adult03 medical and health sciencesSigns and SymptomsDiagnostic MedicineMicrobial ControlSepsisInternal medicinemedicineHumansMeningitisMicrobial PathogensRetrospective StudiesPharmacologyBacteriabusiness.industryOrganismsInfant NewbornBiology and Life SciencesInfantmedicine.diseaseBacterial Loadbusinessdescription
BackgroundInvasive meningococcal disease (IMD) is a highly lethal disease. Diagnosis is commonly performed by culture or Realtime-PCR (qPCR).AimsOur aim was to evaluate, retrospectively, whether culture positivity correlates with higher bacterial load and fatal outcome. Our secondary aim was to compare culture and qPCR sensitivity.MethodsThe National Register for Molecular Surveillance was used as data source. Cycle threshold (CT), known to be inversely correlated with bacterial load, was used to compare bacterial load in different samples.ResultsThree-hundred-thirteen patients were found positive for Neisseria meningitidis by qPCR, or culture, or both; 41 died (case fatality rate 13.1%); 128/143 (89.5%) blood samples and 138/144 (95.8%) CSF were positive by qPCR, 37/143 (25.9%) blood samples and 45/144 (31.2%) CSF were also positive in culture. qPCR was 3.5 times (blood) or 3.1 times (CSF) more sensitive than culture in achieving a laboratory diagnosis of IMD (OR 24.4; 95% CI 12.2-49.8; p ConclusionsIn conclusion our study demonstrated that qPCR is significantly (at least 3 times) more sensitive than culture in the laboratory confirmation of IMD. The study also demonstrated that culture negativity is not associated with lower bacterial loads and with less severe cases. On the other side, in patients with sepsis, qPCR can predict fatal outcome since higher bacterial load, evaluated by qPCR, appears strictly associated with most severe cases and fatal outcome. The study also showed that molecular techniques such as qPCR can provide a valuable addition to the proportion of diagnosed and serotyped cases of IMD.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-01-01 |