Bacterial genomic detection within cerebrospinal fluid of patients with meningococcal disease is influenced by microbial and host characteristics
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Updated: May 30, 2026
10:08
Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
Published on: April 17, 2026
Tom C Darton1, Malcolm Guiver, Simone Naylor
1Department of Infection and Immunity, University of Sheffield, Sheffield, UK.
Abstract:
Among 384 patients with confirmed meningococcal disease, the likelihood of detecting Neisseria meningitidis DNA in cerebrospinal fluid (CSF) increased with age, serogroup B infection, and prehospitalization antibiotic treatment. Plasma and CSF genomic bacterial loads of non-B N. meningitidis serogroups correlated significantly. Serogroup B-infected patients with genotype TNF2 (-308A) had significantly higher CSF bacterial loads.
Insights
Detecting Neisseria meningitidis DNA in cerebrospinal fluid (CSF) is more likely in older patients, those with serogroup B infection, and after antibiotic use. Bacterial loads varied by serogroup and host genetics.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Meningococcal disease is a serious infection caused by Neisseria meningitidis.
- Early detection and understanding factors influencing bacterial load are crucial for patient outcomes.
- Neisseria meningitidis has multiple serogroups, with varying clinical presentations and diagnostic challenges.
Purpose of the Study:
- To investigate factors associated with Neisseria meningitidis DNA detection in cerebrospinal fluid (CSF).
- To analyze the correlation between bacterial loads in plasma and CSF across different serogroups.
- To explore the impact of host genetics, specifically TNF2 (-308A) genotype, on bacterial load in serogroup B infections.
Main Methods:
- Retrospective analysis of 384 patients with confirmed meningococcal disease.
- Quantitative analysis of Neisseria meningitidis DNA in CSF samples.
- Comparison of bacterial loads in plasma and CSF.
- Genotyping for TNF2 (-308A) polymorphism in a subset of patients.
Main Results:
- Detection of Neisseria meningitidis DNA in CSF increased with patient age, serogroup B infection, and prior antibiotic administration.
- Significant correlation observed between plasma and CSF genomic bacterial loads for non-B serogroups.
- Serogroup B infected patients with the TNF2 (-308A) genotype exhibited significantly higher CSF bacterial loads.
Conclusions:
- Age, serogroup B, and prehospital antibiotic treatment are key factors influencing Neisseria meningitidis DNA detection in CSF.
- Host genetics may play a role in bacterial dissemination and load in specific meningococcal infections.
- Findings highlight the complexity of meningococcal disease diagnostics and the need for personalized approaches.
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