Identification of etiological agents by LPA and PCR in childhood meningitis

Mashal Khan,Khatidja Pardhan,Ashfaque Ahmed Memon,Khalid Mahmood A Khan

doi:10.12669/pjms.295.3902

Abstract

To determine the etiological agents by Latex Particle Agglutination (LPA) and Polymerase Chain Reaction (PCR) in patients admitted with Cerebrospinal Fluid (CSF) culture negative bacterial meningitis Methods: This descriptive case series was conducted at National Institute of Child Health, Karachi from January 2010 to December 2012. Patients meeting the WHO case definition of suspected meningitis from one month to 59 months of age were included in the study. CSF examination and culture was carried out on every patient and CSF culture negative patients were enrolled. Demographic data, clinical signs & symptoms and laboratory findings were entered into the proforma. Data was analyzed using statistical package for social sciences (SPSS) version 17. P-value <0.05 was taken as significant. A total of 166 patients were included. Male were 96 and female were 76 with the male to female ratio of 1.26. The mean age of patient was ± SD 14.6 ± 14.5 months. The etiological agents identified by LPA were in 26/166 (15.66%) cases and the organisms were H. influenzae type b 10 cases, streptococcus pneumoniae 15 cases and meningococcus only one case respectively. The organisms identified by PCR were in 65/166 (39.15%) cases and the isolates were H. influenzae type b 16 cases, streptococcus pneumoniae 48 cases and meningococcus 01 case respectively. LPA and PCR are superior and useful diagnostic tools in microbiology. They can be used for rapid etiological diagnosis of bacterial meningitis for the early administration of proper antibiotic. Abbreviation: LPA = Latex Particle Agglutination, PCR = Polymerase Chain Reaction, CSF=Cerebrospinal Fluid, CNS = Central Nervous System.

Highlights

Bacterial meningitis is a serious form of meningoencephalitis that causes inflammation of meninges of the brain, the arachnoid and piamater.[1]
CBC, blood C/S, Gram stain, blood sugar, serum electrolyte and cerebrospinal fluid (CSF) examination was performed on every patient and CSF culture negative patients were enrolled in the study
Latex Particle Agglutination (LPA) and Polymerase Chain Reaction (PCR) techniques were performed on every patient to detect 03 specific antigens for Haemophlus influenzae type b, S. pneumoniae and meningococcus

Summary

Introduction

Bacterial meningitis is a serious form of meningoencephalitis that causes inflammation of meninges of the brain, the arachnoid and piamater.[1]. S. pneumonia and meningococcus contribute to 61% of cases of meningitis.[2,4] Hib meningitis is a disease affecting primarily young children; most of the cases occur in children one month to 3 years of age.[5] The use of Hib conjugate vaccine has reduced the incidence of, or has even virtually eliminated invasive Hib disease in some industrialized countries.[6] Sp is a major cause of childhood bacterial meningitis in countries where Hib disease has been eliminated by vaccination. Meningococcus is considered to be the leading cause of meningitis in many regions of the world causing an estimated 1.2 million cases of bacterial meningitis and sepsis worldwide each year.[8]

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