A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid

Introduction: Acute bacterial meningitis is one of the most severe infectious diseases. Rapid, accurate, and inexpensive diagnosis of bacterial meningitis is crucial for patient management. This study describes a duplex real-time (RT) PCR assay for detection of Neisseria meningitidis and Streptococc...

Full description

Saved in:
Bibliographic Details
Main Authors: Idrissa Diawara, Khalid Katfy, Khalid Zerouali, Houria Belabbes, Naima Elmdaghri
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2016-01-01
Series:Journal of Infection in Developing Countries
Subjects:
Online Access:https://jidc.org/index.php/journal/article/view/5647
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850186695897513984
author Idrissa Diawara
Khalid Katfy
Khalid Zerouali
Houria Belabbes
Naima Elmdaghri
author_facet Idrissa Diawara
Khalid Katfy
Khalid Zerouali
Houria Belabbes
Naima Elmdaghri
author_sort Idrissa Diawara
collection DOAJ
description Introduction: Acute bacterial meningitis is one of the most severe infectious diseases. Rapid, accurate, and inexpensive diagnosis of bacterial meningitis is crucial for patient management. This study describes a duplex real-time (RT) PCR assay for detection of Neisseria meningitidis and Streptococcus pneumoniae in the cerebrospinal fluid (CSF) for meningitis diagnosis using SYBR Green-based RT-PCR method coupled with melting curve analysis. Methodology: We used SYBR Green-based RT-PCR method coupled with melting curve analysis to detect S. pneumoniae and N. meningitidis in CSF samples. The sensitivity, specificity, and limit of detection were determined. The gold standard for routine tests of CSF analysis is direct examination, culture, and/or latex agglutination. The assay was evaluated on 132 CSF samples to measure clinical sensitivity. Results: A duplex RT-PCR assay for N. meningitidis and S. pneumoniae detection in CSF was evaluated. Two peaks at different melting temperatures (87.5°C and 85.5°C) for N. meningitidis and S. pneumoniae, respectively, were obtained. The sensitivity of RT-PCR was 100% (95% confidence limits [CI] = 82.4–100) for N. meningitidis and 100% (95% CI = 85.1–100) for S. pneumoniae. Specificity was the same (100%) for the bacteria (95% CI = 88.6–100). The percentage of cases accurately diagnosed with meningitis caused by N. meningitidis and S. pneumoniae increased to 50.7% and 28.6%, respectively, when RT-PCR was added to the standard microbiologic methods. Conclusions: Duplex RT-PCR and melting curve analysis with SYBR Green is an inexpensive, sensitive, and specific method to rapidly diagnose bacterial meningitis. Accurate identification of the bacterial causative agents will improve patient management and epidemiological investigations.
format Article
id doaj-art-9724e469fb02423b94fe8a09168e37e5
institution OA Journals
issn 1972-2680
language English
publishDate 2016-01-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-9724e469fb02423b94fe8a09168e37e52025-08-20T02:16:18ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802016-01-01100110.3855/jidc.5647A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluidIdrissa Diawara0Khalid Katfy1Khalid Zerouali2Houria Belabbes3Naima Elmdaghri4Faculty of Medicine and Pharmacy, University Hassan II Ain Chock, Casablanca, MoroccoUniversity Hospital Centre Ibn Rochd, Casablanca, MoroccoFaculty of Medicine and Pharmacy, University Hassan II Ain Chock, Casablanca, MoroccoFaculty of Medicine and Pharmacy, University Hassan II Ain Chock, Casablanca, MoroccoFaculty of Medicine and Pharmacy, University Hassan II Ain Chock, Casablanca, MoroccoIntroduction: Acute bacterial meningitis is one of the most severe infectious diseases. Rapid, accurate, and inexpensive diagnosis of bacterial meningitis is crucial for patient management. This study describes a duplex real-time (RT) PCR assay for detection of Neisseria meningitidis and Streptococcus pneumoniae in the cerebrospinal fluid (CSF) for meningitis diagnosis using SYBR Green-based RT-PCR method coupled with melting curve analysis. Methodology: We used SYBR Green-based RT-PCR method coupled with melting curve analysis to detect S. pneumoniae and N. meningitidis in CSF samples. The sensitivity, specificity, and limit of detection were determined. The gold standard for routine tests of CSF analysis is direct examination, culture, and/or latex agglutination. The assay was evaluated on 132 CSF samples to measure clinical sensitivity. Results: A duplex RT-PCR assay for N. meningitidis and S. pneumoniae detection in CSF was evaluated. Two peaks at different melting temperatures (87.5°C and 85.5°C) for N. meningitidis and S. pneumoniae, respectively, were obtained. The sensitivity of RT-PCR was 100% (95% confidence limits [CI] = 82.4–100) for N. meningitidis and 100% (95% CI = 85.1–100) for S. pneumoniae. Specificity was the same (100%) for the bacteria (95% CI = 88.6–100). The percentage of cases accurately diagnosed with meningitis caused by N. meningitidis and S. pneumoniae increased to 50.7% and 28.6%, respectively, when RT-PCR was added to the standard microbiologic methods. Conclusions: Duplex RT-PCR and melting curve analysis with SYBR Green is an inexpensive, sensitive, and specific method to rapidly diagnose bacterial meningitis. Accurate identification of the bacterial causative agents will improve patient management and epidemiological investigations. https://jidc.org/index.php/journal/article/view/5647Neisseria meningitidisStreptococcus pneumoniaemeningitisRT-PCRmelting curve analysis
spellingShingle Idrissa Diawara
Khalid Katfy
Khalid Zerouali
Houria Belabbes
Naima Elmdaghri
A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
Journal of Infection in Developing Countries
Neisseria meningitidis
Streptococcus pneumoniae
meningitis
RT-PCR
melting curve analysis
title A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
title_full A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
title_fullStr A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
title_full_unstemmed A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
title_short A duplex real-time PCR for the detection of Streptococcus pneumoniae and Neisseria meningitidis in cerebrospinal fluid
title_sort duplex real time pcr for the detection of streptococcus pneumoniae and neisseria meningitidis in cerebrospinal fluid
topic Neisseria meningitidis
Streptococcus pneumoniae
meningitis
RT-PCR
melting curve analysis
url https://jidc.org/index.php/journal/article/view/5647
work_keys_str_mv AT idrissadiawara aduplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT khalidkatfy aduplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT khalidzerouali aduplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT houriabelabbes aduplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT naimaelmdaghri aduplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT idrissadiawara duplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT khalidkatfy duplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT khalidzerouali duplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT houriabelabbes duplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid
AT naimaelmdaghri duplexrealtimepcrforthedetectionofstreptococcuspneumoniaeandneisseriameningitidisincerebrospinalfluid