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DIAGNOSIS OF STREPTOCOCCUS PNEUMONIAE MENINGITIS BY POLYMERASE CHAIN REACTION AMPLIFICATION OF THE GENE FOR PNEUMOLYSIN
Meningitis
Polymerase chain reaction
Pneumolysin ply gene
Autor
Afiliación
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bacteriologia. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bacteriologia. Rio de Janeiro, RJ, Brasil.
Instituto Estadual de Infectologia São Sebastião. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bacteriologia. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bacteriologia. Rio de Janeiro, RJ, Brasil.
Instituto Estadual de Infectologia São Sebastião. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bacteriologia. Rio de Janeiro, RJ, Brasil
Resumen en ingles
Diagnosis of bacterial meningitis has long been based on classical methods of Gram stain, serological tests, and culture of cerebrospinal fluid (CSF). The performance of these methods, especially culture and direct smear is thwarted by failure to detect bacteria following administration of antimicrobial agents and reluctance to performance lumbar punctures at admission. Indeed, patients with meningitis frequently receive antibiotics orally or by injection before the diagnosis is suspected or established Thus an alternative method has become necessary to help clinicians and epidemiologists to management and control of bacterial meningitis. We evaluate the application of a polymerase chain reaction-based (PCR) assay for amplification of pneumolysin gene (ply) to diagnosis of Streptococcus pneumoniae meningitis. The PCR assay sensitivity for CSF was 96% (95% confidence interval, CI, 90-99%) compared to a sensitivity of 59% for culture (95% CI 49-69%), 66% for Gram stain (95% CI 56-74%), and 78% for latex agglutination test (95% CI 69-86%); PCR specificity was 100% (95% CI 83-100%). PCR results were available within 4 h of the start of the assay. This molecular approach proved to be reliable and useful to identify this bacterium compared with other classical laboratory methods for identification of bacterial meningitis pathogens.
Palabras clave en ingles
Streptococcus pneumoniaeMeningitis
Polymerase chain reaction
Pneumolysin ply gene
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