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Diagnosis of neonatal meningitis: is it time to use polymerase chain reaction?

Z Zurina1, N P J Hoo2, S Amin-Nordin3

  • 1Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Paediatric, Serdang, Selangor, Malaysia. zaizurina@upm.edu.my.

The Medical Journal of Malaysia
|January 29, 2021
PubMed

Insights

Group B Streptococcus (GBS) causes neonatal meningitis. Polymerase chain reaction (PCR) rapidly diagnosed GBS meningitis in a preterm infant when cultures failed after antibiotic treatment.

Area of Science:

  • Neonatal infectious diseases
  • Microbiology
  • Clinical diagnostics

Background:

  • Group B Streptococcus (GBS) is a leading cause of neonatal meningitis, resulting in significant mortality and morbidity.
  • Antenatal screening and chemoprophylaxis have reduced GBS disease incidence in developed nations but are less common in developing countries.
  • Prompt diagnosis and treatment are crucial for infant recovery from GBS infections.

Observation:

  • A case of early-onset GBS meningitis in a preterm male infant is presented.
  • Blood and cerebrospinal fluid (CSF) cultures were negative due to antibiotic administration prior to sample collection.
  • Polymerase chain reaction (PCR) was performed on CSF for pathogen detection.

Findings:

  • PCR successfully detected GBS in the infant's CSF, enabling a definitive diagnosis.
  • The PCR method proved crucial for identifying the pathogen when conventional culture methods were unsuccessful.
  • This highlights the utility of PCR in diagnosing GBS meningitis under challenging clinical circumstances.

Implications:

  • Polymerase chain reaction (PCR) offers a potentially rapid and accurate diagnostic tool for neonatal infections.
  • Implementing advanced diagnostic techniques like PCR can improve outcomes for newborns with suspected GBS meningitis.
  • Further integration of PCR into diagnostic algorithms may enhance the management of neonatal sepsis in resource-limited settings.

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