Performance characteristics of the polymerase chain reaction assay to confirm clinical meningococcal disease
| Autor: | E B Kaczmarski, Enitan D. Carrol, S.J. Gray, C. A. Hart, A. P. J. Thomson, P. Shears |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Enzyme-Linked Immunosorbent Assay Meningococcal disease Gastroenterology Polymerase Chain Reaction Sensitivity and Specificity Predictive Value of Tests Internal medicine Medicine Humans Blood culture Prospective Studies Child Antigens Bacterial medicine.diagnostic_test business.industry Methodology Gold standard (test) medicine.disease Rash United Kingdom Penicillin Meningococcal Infections Predictive value of tests Child Preschool Pediatrics Perinatology and Child Health Immunology Female Bacterial antigen medicine.symptom business Meningitis medicine.drug |
| Zdroj: | Archives of disease in childhood. 83(3) |
| ISSN: | 1468-2044 |
| Popis: | BACKGROUND Confirmation of clinical meningococcal disease (MCD) is essential for management of patients, contacts, and outbreaks. Blood and CSF cultures, the traditional gold standard diagnostic tests, have been adversely affected by preadmission parenteral penicillin and fewer lumbar punctures. Rapid, reliable serogroup determination without the need to grow isolates could improve laboratory confirmation of MCD. AIMS To determine performance characteristics of the currently available meningococcal polymerase chain reaction (PCR) assays in a clinical setting. METHODS Prospective study of 319 children presenting with a suspected diagnosis of MCD (fever and a rash, or suspected bacterial meningitis) over a 16 month period. RESULTS A total of 166 (52% of all) children had clinical MCD: diagnosis was confirmed microbiologically in 119 (72%) of these. Performance characteristics (sensitivity, specificity, negative predictive value, positive predictive value) in confirmation of clinical MCD were respectively (95% confidence interval): blood culture 31% (24–38%), 100%, 57% (49–65%), 100%; blood PCR 47% (39–55%), 100%, 65% (58–73%), 100%; any test positive 72% (65–79%), 100%, 77% (70–84%), 100%. CONCLUSIONS Meningococcal DNA detection in blood or CSF by PCR is a useful method of diagnosis of MCD. PCR of peripheral blood performs better than blood culture. In a child with clinically suspected MCD, PCR assays, bacterial antigen tests, and oropharyngeal swabbing for meningococcal carriage should be performed in addition to blood or CSF culture, to improve case confirmation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|