Added value of PCR-testing for confirmation of invasive meningococcal disease in England

Ellen Heinsbroek, Shamez Ladhani, Steve Gray, Malcolm Guiver, Edward Kaczmarski, Raymond Borrow, Mary Ramsay

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)

Abstract

Objectives: In England, national guidance recommends that all patients with suspected invasive meningococcal disease (IMD) should be investigated by blood culture and polymerase chain reaction (PCR) testing. The Meningococcal Reference Unit (MRU) provides a national service for meningococcal species confirmation and PCR-testing of clinical samples. We performed a population-level assessment of the added value of PCR-testing for IMD to augment traditional culture confirmation. Methods: We analysed all PCR-samples and invasive meningococcal isolates received by MRU in 2009 and 2010. We assumed that all patients with PCR-samples submitted to MRU also had blood cultures performed and that positive blood cultures were referred to MRU. We confirmed this assertion by case ascertainment. Results: In total, 25,379 specimens from 22,039 patients were submitted for PCR-testing and 1492 (6.8%) tested PCR-positive. MRU received 825 invasive meningococcal isolates; 393 confirmed by PCR and culture, 405 without a PCR-specimen submitted and 27 with a PCR-negative result. Thus, of 1924 reported IMD cases, 1099 (57.1%) were confirmed by PCR only, 432 (22.5%) by culture only and 393 (20.4%) by both tests. Conclusion: More than half of all confirmed IMD cases were confirmed by PCR only, indicating this service ensures high case ascertainment for national surveillance.

Original languageEnglish
Pages (from-to)385-390
Number of pages6
JournalJournal of Infection
Volume67
Issue number5
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Bacterial infections
  • Diagnosis
  • Invasive meningococcal disease
  • Meningococcal infections
  • Neisseria meningitidis
  • Polymerase chain reaction
  • Surveillance

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