Summary
Objectives
In England, national guidance recommends that all patients with suspected invasive
meningococcal disease (IMD) should be investigated by blood culture and polymerase
chain reaction (PCR) testing. The Meningococcal Reference Unit (MRU) provides a national
service for meningococcal species confirmation and PCR-testing of clinical samples.
We performed a population-level assessment of the added value of PCR-testing for IMD
to augment traditional culture confirmation.
Methods
We analysed all PCR-samples and invasive meningococcal isolates received by MRU in
2009 and 2010. We assumed that all patients with PCR-samples submitted to MRU also
had blood cultures performed and that positive blood cultures were referred to MRU.
We confirmed this assertion by case ascertainment.
Results
In total, 25,379 specimens from 22,039 patients were submitted for PCR-testing and
1492 (6.8%) tested PCR-positive. MRU received 825 invasive meningococcal isolates;
393 confirmed by PCR and culture, 405 without a PCR-specimen submitted and 27 with
a PCR-negative result. Thus, 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 tests.
Conclusion
More than half of all confirmed IMD cases were confirmed by PCR only, indicating this
service ensures high case ascertainment for national surveillance.
Keywords
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Article info
Publication history
Published online: June 24, 2013
Accepted:
June 17,
2013
Identification
Copyright
© 2013 The British Infection Association. Published by Elsevier Inc. All rights reserved.
