Abstract
Bacterial meningitis is a major global cause of morbidity and mortality. Rapid identification of the aetiological agent of meningitis is essential for clinical and public health management and disease prevention given the wide range of pathogens that cause the clinical syndrome and the availability of vaccines that protect against some, but not all, of these. Since microbiological culture is complex, slow, and often impacted by prior antimicrobial treatment of the patient, molecular diagnostic assays have been developed for bacterial detection. Distinguishing between meningitis caused by Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Streptococcus agalactiae and identifying their polysaccharide capsules is especially important. Here, we review methods used in the identification of these bacteria, providing an up-to-date account of available assays, allowing clinicians and diagnostic laboratories to make informed decisions about which assays to use.
Highlights
Bacterial meningitis, which can be accompanied by sepsis, is an infection causing significant morbidity and mortality worldwide [1]
Many pathogens can invade the membranes lining the brain and spinal cord and cause syndromic meningitis; the condition can become rapidly fatal if untreated when caused by the encapsulated bacteria Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and Streptococcus agalactiae
Molecular tools including the polymerase chain reaction (PCR), real-time PCR, qualitative or quantitative PCR, and loop-mediated isothermal amplification assays (LAMP) have the potential to overcome many of the limitations of culture-based approaches, as they target bacterial DNA and are not constrained by the presence of cultivable organisms
Summary
Bacterial meningitis, which can be accompanied by sepsis, is an infection causing significant morbidity and mortality worldwide [1]. Children, and adolescents (aged 10À19 years) bacterial meningitis caused by these organisms typically presents with symptoms including headache, fever, photophobia, vomiting, and neck stiffness [2]. In newborns (1 to 28 days), infants (up to 12 months) and young children (from 1 to 10 years), the symptoms and signs are non-specific, including lethargy, poor feeding, vomiting and irritability associated with fever [3]. Accurate and specific identification of the causative organism is necessary to ensure an effective public health response is elicited and appropriate clinical management, such as antimicrobial prophylaxis, can be established with or without vaccination of contacts
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