Impact of molecular point-of-care testing on surveillance and public health management of invasive meningococcal disease

Objectives To assess the use of fully integrated, molecular point-of-care testing (POCT) platforms for meningitis diagnosis in England, and its impact on invasive meningococcal disease (IMD) surveillance and strain characterization. Case confirmation and strain characterization, important for informing the public health response, is often not possible following POCT. Methods The use of POCT for meningitis diagnosis was determined using a survey of English microbiology laboratories. Furthermore, national laboratory and public health databases were used to identify IMD cases diagnosed by POCT-only, without characterization, from 2022 to 2024. Results The survey indicated that at least 23 laboratories were using a POCT platform for meningitis diagnosis in 2024. Between 2022 and 2024, 1009 cases of IMD were confirmed, and we identified 14 confirmed only by POCT, increasing from 1 in 2022 to 9 in 2024. All POCT-only cases were notified to the local health protection teams; however, crucial public health actions may have been missed. Conclusion Although the number of IMD cases confirmed solely by POCT remains low, use of POCT is increasing. The impact on IMD surveillance, strain characterization and public health response must be carefully monitored to ensure that case management, outbreak detection and national disease trends are not adversely affected.