Incorporation of Real-Time PCR into Routine Public Health Surveillance of Culture Negative Bacterial Meningitis in São Paulo, Brazil
2011

Using Real-Time PCR for Bacterial Meningitis Surveillance in Brazil

Sample size: 499 publication 10 minutes Evidence: high

Author Information

Author(s): Sacchi Claudio T., Fukasawa Lucila O., Gonçalves Maria G., Salgado Maristela M., Shutt Kathleen A., Carvalhanas Telma R., Ribeiro Ana F., Kemp Brigina, Gorla Maria C. O., Albernaz Ricardo K., Marques Eneida G. L., Cruciano Angela, Waldman Eliseu A., Brandileone M. Cristina C, Harrison Lee H.

Primary Institution: Instituto Adolfo Lutz, São Paulo, Brazil

Hypothesis

Can real-time PCR improve the diagnosis of bacterial meningitis in a developing country?

Conclusion

Real-time PCR significantly increases the diagnostic yield for bacterial meningitis and is suitable for routine public health surveillance in Brazil.

Supporting Evidence

  • RT-PCR sensitivity was 100% for N. meningitidis and 97.8% for S. pneumoniae.
  • Addition of RT-PCR increased detection yield by 52% for S. pneumoniae cases.
  • Presence of antibiotics in CSF was a major risk factor for culture-negative, RT-PCR positive cases.

Takeaway

This study shows that a special test called RT-PCR can help doctors find out if someone has bacterial meningitis, even when regular tests don't work.

Methodology

The study validated a multiplex RT-PCR assay for detecting bacterial meningitis pathogens in cerebrospinal fluid and serum samples from patients.

Potential Biases

Potential bias due to the retrospective nature of data collection and reliance on existing medical records.

Limitations

The study may not be generalizable to all regions due to differences in healthcare practices and antibiotic use.

Participant Demographics

Median age was 9 years, with 60.9% male and 9.6% recorded as deceased.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI 5.9-25.0

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0020675

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication