Increasing microbiological confirmation and changing epidemiology of meningococcal disease on Merseyside, England
| Autor: | A. P. J. Thomson, F. A. I. Riordan, P. Shears, C. A. Hart, J M Fellick, J. A. Sills, Enitan D. Carrol |
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| Rok vydání: | 2000 |
| Předmět: |
DNA
Bacterial Male Microbiology (medical) medicine.medical_specialty Adolescent polymerase chain reaction Neisseria meningitidis Meningococcal disease Internal medicine Agglutination Tests Epidemiology medicine Humans EPOCH (chemotherapy) Prospective Studies Prospective cohort study Child meningococcal disease Antigens Bacterial microbiological medicine.diagnostic_test business.industry Lumbar puncture Incidence (epidemiology) Incidence Infant General Medicine medicine.disease antigen detection Surgery Penicillin Meningococcal Infections Infectious Diseases England Child Preschool Female Bacterial antigen business psychological phenomena and processes medicine.drug |
| Zdroj: | Clinical Microbiology and Infection. 6(5):259-262 |
| ISSN: | 1198-743X |
| DOI: | 10.1046/j.1469-0691.2000.00078.x |
| Popis: | Objectives To determine, for the last 5 years in children on Merseyside with clinical meningococcal disease (MCD), the impact on diagnostic yield of newer bacteriologic methods; bacterial antigen detection (AD) and polymerase chain reaction (PCR). Methods Prospective data collection at Royal Liverpool Children's Hospital over two epochs: 1 September 1992 to 30 April 1994 (epoch A, n = 126) and 17 November 1997 to 15 September 1998 (epoch B, n = 85). Results Epoch Awas compared with epoch B. Diagnosis was confirmed by detection of meningococci in 78 of 126 (61.9%) versus 64 of 85 (75.3%, P = 0.04), but with a significantly lower rate of positive blood and cerebrospinal fluid culture in the later epoch. The proportion of cases receiving penicillin pretreatment was unchanged at 32%, but the proportion undergoing lumbar puncture decreased significantly. Median ages were higher in epoch B: 1.7 years versus 2.49 years ( P = 0.013, Mann-Whitney). There was a significant increase in the proportion of cases due to serogroup C (14/78 (18%) versus 30/64 (46.9%), P = 0.001). Conclusions Culture detection of meningococci from children with MCD has reduced, as less lumbar punctures are done. However, improved diagnosis by PCR and AD has increased microbiological confirmation overall. Serogroup C disease and the median age of cases continue to rise. |
| Databáze: | OpenAIRE |
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