Over the last five years there has been a growing discrepancy between the number of clinically diagnosed cases and cases confirmed by bacterial culture, possibly due to earlier penicillin or fears about the safety of lumbar puncture.
A molecular test called PCR is currently used in the national reference laboratory in Manchester to identify the species and strain of bacteria in cases of meningitis and septicaemia. PCR can detect minuscule amounts of bacterial DNA in blood as well as cerebrospinal fluid, and can work even after bacteria have been killed with antibiotics.
In this project, PCR assays which are both sensitive and specific to viral and bacterial causes of meningitis and septicaemia, and which differentiate between strains of meningococcal disease are being developed. These assays will provide confirmed and strain-specific diagnosis within hours of receiving the sample so that a decision to vaccinate contacts of a case can be made quickly if group C meningococcal infection is proven.
The project is taking place at the Meningococcal Reference Unit in Manchester, which receives samples from clinically diagnosed patients in hospitals throughout the UK, and plays a major role in national surveillance and control of meningococcal infection.
Results from this study have been published in scientific journals as follows:
Corless CE, Guiver M, Borrow R, Edwards-Jones V, Kaczmarski EB, Fox AJ.
Contamination and sensitivity issues with a real-time universal 16S rRNA PCR.
J Clin Microbiol 2000 May;38(5):1747-52.
Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB.
Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR.
J Clin Microbiol 2001 Apr;39(4):1553-8.
Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB, Mutton KJ.
Development and evaluation of a 'real-time' RT-PCR for the detection of enterovirus and parechovirus RNA in CSF and throat swab samples.
J Med Virol 2002 Aug;67(4):555-62.