The utility of the polymerase chain reaction assay for aetiologic definition of unspecified bacterial meningitis cases

Tuyama, Mari; Boente, Renata F.; Rebelo, Maria Cristina; Igreja, Ricardo Pereira; Barroso, David E.

doi:10.1590/s0074-02762008000200003

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…17 Until recently, penicillin resistance among meningitis-causing S. pneumoniae remained at low frequency in Rio de Janeiro, but it increased, together with the emergence of ceftriaxone resistance, after 2003. Although a similar trend was also reported elsewhere in Brazil (2000–2004), 18 it has not been associated with a clonal complex as we have shown earlier.…”

Section: Discussionmentioning

confidence: 99%

“…Antibiotic resistance is a particular threat in regions where there are a large number of meningitis cases of unknown cause, or where the bacteria cannot be cultured from clinical specimens and the etiologic agent is identified solely by antigen detection, 17 because β -lactams resistance can go undetected if clinical specimens from a sterile site cannot be cultured. Another challenge involving the treatment of meningitis patients is the reduced number of local hospitals routinely performing pneumococcal susceptibility testing or capable of determining antibiotics MICs to bacterial meningitis pathogens, which might influence therapeutic decision and patient outcome.…”

Section: Discussionmentioning

confidence: 99%

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β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil

Barroso¹,

Godoy²,

Castiñeiras³

et al. 2012

Pediatric Infectious Disease Journal

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Background Here, we report a laboratory-based study of Streptococcus pneumoniae recovered from patients with meningitis in Rio de Janeiro State, Brazil. Methods The aim of this study was to determine the evolution of β-lactam resistance, antimicrobial susceptibility pattern, serotypes, and genetic diversity of S. pneumoniae, isolated from meningitis patients between 2000 and 2008. Results A total of 264 S. pneumoniae recovered from patients between 2000 and 2008 were included. Susceptibility testing (E-test) of S. pneumoniae showed resistance to penicillin, ceftriaxone, oxacillin, cotrimoxazole, tetracycline, ofloxacin, erythromycin, chloramphenicol, and rifampicin. Penicillin resistance (PEN-R, minimal inhibitory concentration [MIC] ≥0.12 μg/mL) increased from 8% of isolates in 2000–2002, to 12% in 2003–2005, and to 20% in 2006–2008. Ceftriaxone resistance (MIC ≥1.0 μg/mL) was detected among some PEN-R isolates (13%) from 2004 onward. Within the PEN-R isolates, serotypes that are included in 10-valent pneumococcal conjugate vaccine predominated (90%), and resistance was detected mostly in isolates of serotypes 14 (61%), 23F (16%), 6B (10%), and 19F (3%). Multilocus sequence typing showed that 52% of the PEN-R isolates, and 89% of those with MICs ≥0.5 μg/mL, were sequence type (ST)-156 or single-locus variants of this ST (ST-557 or ST-4388); all of these isolates were serotype 14 and were assigned to the Spain9V-3 clone. Conclusions β-lactam resistance increased recently among cerebrospinal fluid isolates and was mainly due to the surge of the ST-4388, a previously undescribed gki single-locus variants of ST-156. Regional surveillance is shown to be essential to provide optimal antimicrobial therapy, monitor highly successful clones, and formulate adequate vaccination strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil

Barroso¹,

Godoy²,

Castiñeiras³

et al. 2012

Pediatric Infectious Disease Journal

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“…There was no significant change in the surveillance system in the vaccine era. The results obtained with PCR to detect H. influenzae are restricted to the period of validation of a PCR assay between 2004 and 2006; PCR has not been introduced into routine practice ( Tuyama et al 2008 ). From 1986 to 2014, surveillance data were provided by the State Department of Health.…”

Section: Methodsmentioning

confidence: 99%

Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil

Tuyama

Corrêa-Antônio

Schlackman

et al. 2017

Mem. Inst. Oswaldo Cruz

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BACKGROUND Haemophilus influenzae (Hi) serotype b (Hib) conjugate vaccine was incorporated into the infant immunisation schedule in Brazil in 1999, where Hib was one of the major etiologic sources of community-acquired bacterial meningitis.OBJECTIVES The purpose of this study is to describe the molecular epidemiology of invasive Hi disease in Rio de Janeiro state, Brazil, before and after vaccine introduction.METHODS Surveillance data from 1986 to 2014 were analysed. Hi isolates recovered from cerebrospinal fluid (CSF) or blood from 1993 to 2014 were serotyped by slide agglutination, genotyped by multilocus sequence typing (MLST), and the capsule type evaluation, differentiation of serologically non-typeable isolates, and characterisation of the capsule (cap) locus was done by polymerase chain reaction. Antimicrobial susceptibility testing was performed using E-test.FINDINGS From 1986 to 1999 and from 2000 to 2014, 2580 and 197 (42% without serotype information) confirmed cases were reported, respectively. The case fatality rate was 17% and did not correlate with the strain. Hib and b- variant isolates belonged to ST-6, whereas serotype a isolates belonged to the ST-23 clonal complex. Serotype a appeared to emerge during the 2000s. Non-encapsulated isolates were non-clonal and distinct from the encapsulated isolates. Ampicillin-resistant isolates were either of serotype b or were non-encapsulated, and all of them were β-lactamase-positive but amoxicillin-clavulanic acid susceptible.MAIN CONCLUSIONS Although Hi meningitis became a relatively rare disease in Rio de Janeiro after the introduction of the Hib conjugate vaccine, the isolates recovered from patients have become more diverse. These results indicate the need to implement an enhanced surveillance system to continue monitoring the impact of the Hib conjugate vaccine.

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“…Polymerase chain reaction (PCR) assay can quickly and specifically detect bacteria in blood and CSF for diagnosing bacterial meningitis . In particular, species‐specific multiplex PCR (mPCR) can quickly and specifically detect more than one bacterial species simultaneously . To date, no published mPCR methods have addressed the simultaneous detection of common pathogenic bacteria that cause acute adult meningitis in Taiwan.…”

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confidence: 99%

Multiplex polymerase chain reaction assay developed to diagnose adult bacterial meningitis in Taiwan

Lee¹,

Hsiao

Chen

et al. 2015

APMIS

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Acute bacterial meningitis causes high morbidity and mortality; the associated clinical symptoms often are insensitive or non-specific; and the pathogenic bacteria are geographically diverse. Clinical diagnosis requires a rapid and accurate methodology. This study aimed to develop a new multiplex polymerase chain reaction (mPCR) assay to detect simultaneously six major bacteria that cause adult bacterial meningitis in Taiwan: Klebsiella pneumoniae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, and Acinetobacter baumannii. Species-specific primers for the six bacteria were developed using reference strains. The specificities of the mPCRs for these bacteria were validated, and the sensitivities were evaluated via serial dilutions. The mPCR assay specifically detected all of the six pathogens, particularly with sensitivities of 12 colony forming units (CFU)/mL, 90 CFU/mL, and 390 CFU/mL for E. coli, S. pneumoniae, and K. pneumoniae, respectively. This mPCR assay is a rapid and specific tool to detect the six major bacterial pathogens that cause acute adult meningitis in Taiwan, particularly sensitive for detecting E. coli, S. pneumoniae, and K. pneumoniae. The assay may facilitate early diagnosis and guidance for antimicrobial therapy for adult patients with this deadly disease in Taiwan.

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The utility of the polymerase chain reaction assay for aetiologic definition of unspecified bacterial meningitis cases

Cited by 9 publications

References 29 publications

β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil

β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil

Invasive Haemophilus influenzae disease in the vaccine era in Rio de Janeiro, Brazil

Multiplex polymerase chain reaction assay developed to diagnose adult bacterial meningitis in Taiwan

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