Mohamed N, Abubokr A
Background: Bacterial meningitis (BM) is a medical emergency in children. Delay in diagnosis and treatment remain major concerns in the management of BM. The aim of this study was the use of multiplex PCR (mPCR) for simultaneous detection of Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, and S. agalactiae in suspected patient cerebrospinal fluid (CSF).
Methods and findings: 712 CSF specimens were collected from the patients of age <5 years having clinical features suggestive of meningitis. 300 samples were randomly taken from the set of CSF specimens whose culture was negative and analyzed by mPCR. The positive bacterial growth was obtained from only 2 (0.2%) CSF samples. The pathogens identified were Salmonella sp and Citrobacter freundii. PCR analysis of the randomly selected 300 CSF specimens revealed the following pathogens: S. pneumoniae (n=7), H. influenzae (n=3) and N. meningitidis (n=2). No S. agalactiae isolate was detected in the CSF specimens. Serogrouping of S. pneumoniae isolates that 4 strains belong to the serogroup 19A and three strains to the serogroup 23F. For N. meningitidis, serogroup prediction showed that the 2 isolates detected belong to serogroup A.
Conclusions: Our study emphasizes the importance of PCR as the most common method that is sufficiently accurate and reliable, and it should be included for bacterial detection in all negative cultures. It also reveals that these four bacterial meningitis agents are still an important cause of children meningitis.