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Visualisation and Quantification of Intracellular Interactions of Neisseria meningitidis and Human α-actinin by Confocal Imaging
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Increasing microbiological confirmation and changing epidemiology of meningococcal disease on Merseyside, England

E D Carrol1, A P Thomson, F A Riordan

  • 1Institute of Child Health, Royal Liverpool Children's NHS Trust, Liverpool, UK. edcarrol@liverpool.ac.uk

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|February 13, 2001
PubMed
Abstract

Insights

Newer diagnostic methods like PCR and antigen detection have improved overall confirmation rates for meningococcal disease in children. Despite fewer cultures, these advances enhance microbiological diagnosis, with rising Serogroup C cases and older patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Diagnostic Accuracy

Background:

  • Meningococcal disease (MCD) remains a significant concern in pediatric populations.
  • Traditional diagnostic methods for MCD rely on bacterial cultures, which can be challenging.
  • Advancements in molecular and antigen-based diagnostics offer potential improvements in detection rates.

Purpose of the Study:

  • To evaluate the impact of newer bacteriologic methods, specifically bacterial antigen detection (AD) and polymerase chain reaction (PCR), on the diagnostic yield for pediatric meningococcal disease.
  • To compare diagnostic yields over two distinct time periods to assess the influence of evolving diagnostic techniques.

Main Methods:

  • Prospective data collection was conducted at a children's hospital over two epochs (1992-1994 and 1997-1998).
  • Diagnostic confirmation rates were compared between the two epochs, analyzing results from bacterial cultures, AD, and PCR.
  • Patient demographics, including age and serogroup distribution, were also analyzed.

Main Results:

  • Overall microbiological confirmation of meningococcal disease increased from 61.9% to 75.3% between the epochs (P=0.04).
  • Despite a decrease in positive blood and cerebrospinal fluid cultures, likely due to reduced lumbar punctures, the use of PCR and AD improved overall detection.
  • A significant rise in cases attributed to serogroup C (18% to 46.9%, P=0.001) and an increase in median patient age were observed.

Conclusions:

  • While traditional culture-based detection of meningococci has decreased due to fewer lumbar punctures, newer methods like PCR and AD have enhanced overall microbiological confirmation rates.
  • The incidence of serogroup C meningococcal disease and the median age of affected children are increasing.
  • These findings highlight the evolving landscape of meningococcal disease diagnostics and epidemiology in children.

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