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Added value of PCR-testing for confirmation of invasive meningococcal disease in England

Ellen Heinsbroek1, Shamez Ladhani, Steve Gray

  • 1European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Immunisation, Hepatitis & Blood Safety Department, Public Health England, London, United Kingdom.

The Journal of Infection
|June 26, 2013
PubMed
Abstract

Insights

Polymerase chain reaction (PCR) testing confirms over half of invasive meningococcal disease (IMD) cases, significantly improving national surveillance. This molecular diagnostic method enhances case ascertainment beyond traditional blood cultures.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • National guidelines in England mandate blood culture and PCR testing for suspected invasive meningococcal disease (IMD).
  • The Meningococcal Reference Unit (MRU) offers national services for IMD confirmation and PCR testing.
  • A population-level assessment was conducted to evaluate the added value of PCR testing for IMD.

Purpose of the Study:

  • To assess the added value of PCR testing in augmenting traditional culture confirmation for invasive meningococcal disease (IMD).
  • To evaluate the contribution of PCR testing to national surveillance of IMD.

Main Methods:

  • Analysis of all PCR samples and invasive meningococcal isolates submitted to the MRU during 2009-2010.
  • Assumption that all patients with PCR samples also had blood cultures performed, with positive cultures referred to MRU.
  • Case ascertainment was used to confirm the assertion of concurrent blood culture performance.

Main Results:

  • A total of 25,379 specimens from 22,039 patients were tested via PCR, with 1492 (6.8%) testing positive.
  • MRU received 825 invasive meningococcal isolates; 393 were confirmed by both PCR and culture.
  • Out of 1924 reported IMD cases, 1099 (57.1%) were confirmed by PCR only, 432 (22.5%) by culture only, and 393 (20.4%) by both.

Conclusions:

  • PCR testing alone confirmed over half of all invasive meningococcal disease (IMD) cases.
  • The national PCR testing service ensures high case ascertainment for IMD surveillance.
  • PCR testing significantly enhances the detection of IMD compared to culture alone.
Keywords:
Bacterial infectionsDiagnosisInvasive meningococcal diseaseMeningococcal infectionsNeisseria meningitidisPolymerase chain reactionSurveillance

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