[The use of polymerase chain reaction in the diagnosis of invasive meningococcal disease]

Abstract

Introduction and objectives and aims: Invasive meningococcal disease (IMD) remains a serious public health problem. Although culture is the gold standard, previous antibiotic therapy reduces its sensibility. The aim of this study is the epidemiological analysis of IMD in our area, to assess the usefulness of polymerase chain reaction (PCR) to increase its diagnostic accuracy,and to show the association of antibiotic administration with the negative result of the culture.

Patients and methods: A retrospective study was conducted on all children younger than 16 years with microbiologically (positive culture and/or PCR) confirmed IMD, admitted to our hospital between 2004-2012.

Results: Seventy-five patients were included, of whom 52% had sepsis, 30.7% meningitis, and 17.3% with both of them. PCR was positive in all samples, whereas a positive was seen 50.7% of the cultures. Previously administered antibiotic was documented in 40 patients (53.3%), and 40% of them were confirmed by PCR only.

Conclusions: PCR was the only test providing evidence for IMD diagnosis and serogroup determination in almost 39% of cases.

Keywords: Enfermedad meningocócica; Infección por meningococo; Meningitis por meningococo; Meningococcal disease; Meningococcal infections; Meningococcal meningitis; Polymerase chain reaction; Reacción en cadena de la polimerasa.