Improved Real Time PCR assay for diagnostic and epidemiological surveillance of bacterial meningitis
Keywords:
Bacterial meningitis, Real time PCR, Haemophilus influenzaeAbstract
Incorporation of a triplex assay on Real-Time PCR (PCR-TR) to bacterial meningitis surveillance, started in 2007, increased the detection of S. pneumoniae in 52%, of N. meningitidis in 85% and H. influenzae in 20%. Nevertheless H.influenzae (Hi) detection was limited to capsule strains of 4 serotypes (“a”, “b”, “c”, “d”). In 2011 a new assay, designed to detect all serotypes of H. influenzae, including non-typed H. influenzae, was proposed, with the replacement of the bexA gene by the hpd gene in the triplex assay (“modified triplex”), responsible by the D protein of H. influenzae. The analysis was performed in 1619 clinical samples of cerebrospinal fluid and/or blood from patients suspicious of bacterial meningitis in the city of São Paulo, during the period comprised between June and December, 2011, in both PCR-RT “triplex” formats. The new “modified triplex” format assay (with the hpd gene) detected 13 more cases than the previous format (with the bexA gene). Of these 13 additional cases, 12 were Hi-nt and one of the “f” serotype. There was no change in the sensitivity to detect positive samples for N.meningitidis or S. pneumoniae. Adoption of the new “triplex modified” format will improve diagnosis and epidemiologic surveillance of bacterial meningitis, contributing to the reduction of meningitis cases with undefined etiology.
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Copyright (c) 2013 Maristela Marques Salgado, Fábio Takenori Higa, Maria Gisele Gonçalves, Lucila Okuyama Fukasawa, Bernadete Lourdes Liphaus, Priscilla Lima de Oliveira, Carla Naufal da Silva, Cláudio Tavares Sacchi
This work is licensed under a Creative Commons Attribution 4.0 International License.
