TY - JOUR
T1 - Added value of PCR-testing for confirmation of invasive meningococcal disease in England
AU - Heinsbroek, Ellen
AU - Ladhani, Shamez
AU - Gray, Steve
AU - Guiver, Malcolm
AU - Kaczmarski, Edward
AU - Borrow, Raymond
AU - Ramsay, Mary
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/11
Y1 - 2013/11
N2 - 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.
AB - 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.
KW - Bacterial infections
KW - Diagnosis
KW - Invasive meningococcal disease
KW - Meningococcal infections
KW - Neisseria meningitidis
KW - Polymerase chain reaction
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84884703665&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2013.06.007
DO - 10.1016/j.jinf.2013.06.007
M3 - Article
C2 - 23796865
AN - SCOPUS:84884703665
SN - 0163-4453
VL - 67
SP - 385
EP - 390
JO - Journal of Infection
JF - Journal of Infection
IS - 5
ER -