Using new genomic techniques to identify the causes of meningitis in UK children

Improving the speed, accuracy and cost of diagnosing meningitis in children in the UK by using new genomic techniques

Researchers
Prof Andrew Pollard, Dr Paolo Piazza, Dr Rory Bowden, Dr Manish Sadarangani, Dr Dominic Kelly, Dr Mary Ramsay, Prof Ray Borrow, Dr Simon Nadel, Prof Paul Heath, , Prof Tom Solomon, Dr Michael Griffiths
Start Date
14 May 2015
Category
Diagnosis and Treatment
Organisation
University of Oxford, UK, Public Health England, UK, St Mary's Hospital, UK, St George's University of London, UK, University of Liverpool, UK

What is this project about?

The overall aim of this study is to improve the speed, accuracy and cost of diagnosing meningitis in children in the UK by using new genomic techniques. Using samples collected from children in another MRF project, the team will develop a new method to be used for the diagnosis of meningitis, analysing the genetic material of microorganisms found in CSF (cerebrospinal fluid). The new method will first be developed using CSF samples where the microorganism is known, but then will be applied to CSF samples where the microorganism is unknown (estimated at around 40%) to try and identify a cause. With this new data, and combined with surveillance data from Public Health England, this project will be able to provide more accurate numbers on the microbiological causes on meningitis in UK children.

Why is it important?

Historically the focus of meningitis research has been around bacteria as this has the worst outcomes and is treatable with antibiotics. 

Highly effective vaccines have dramatically reduced meningitis caused by many different types of bacteria in the past 20 years. It means that in the UK, most children who now contract meningitis have what is referred to as ‘aseptic meningitis’, where there is inflammation of the meninges (lining of the brain and spinal cord) but no bacteria can be grown from the CSF.

Current methods of finding the cause in these children are not very good and in around half of these cases, no cause is ever found, despite multiple tests done in the laboratory. 

This new method could provide a better way of finding a cause in a greater number of meningitis cases.

Potential outcomes

The goal is to develop a new genomic technique which will be further developed to deliver a one-stop diagnostic test for meningitis, thereby:
 

  • Increasing the proportion of cases in which a cause is identified
  • Reducing the time taken to diagnose meningitis
  • Reducing the cost to the healthcare system by reducing the number of tests required

This would also:
 

  • Allow more appropriate use of antibiotics and other treatments (e.g. steroids are needed quickly for those with bacterial meningitis)
  • Reduce the time in hospital for children who do not have bacterial meningitis
  • Direct future drug and vaccine development through more accurate identification of the current causes of meningitis
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