Management of early meningococcal disease

Cartwright, Keith; Reilly, Sheena; White, D.; Stuart, James M.; Begg, Norman; Constantine, C. E.; Hochuli, Vernon

doi:10.1016/0140-6736(93)92030-w

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…For the meningococcus, for example, the information obtained has proven to be invaluable for the understanding and management of disease outbreaks (31,32), epidemiological surveillance (33,34), and the monitoring of public health interventions. Its application to clinical specimens has obvious implications for diagnosis and clinical management of cases caused by an organism that is notoriously difficult to isolate microbiologically from patients undergoing antibiotic therapy (35-37).…”

Section: Methodsmentioning

confidence: 99%

Multilocus Sequence Typing

Pavón

Maiden

2009

Methods in Molecular Biology

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Multilocus sequence typing (MLST) was first proposed in 1998 as a typing approach that enables the unambiguous characterization of bacterial isolates in a standardized, reproducible, and portable manner using the human pathogen Neisseria meningitidis as the exemplar organism. Since then, the approach has been applied to a large and growing number of organisms by public health laboratories and research institutions. MLST data, shared by investigators over the world via the Internet, have been successfully exploited in applications ranging from molecular epidemiological investigations to population biology and evolutionary analyses. This chapter describes the practical steps in the development and application of an MLST scheme and some of the common tools and techniques used to obtain the maximum benefit from the data. Considerations pertinent to the implementation of high-capacity MLST projects (i.e., those involving thousands of isolates) are discussed.

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Section: Methodsmentioning

confidence: 99%

Multilocus Sequence Typing

Pavón

Maiden

2009

Methods in Molecular Biology

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“…However, rapid aetiological diagnosis and serogroup determination are crucial. Culture-confirmed diagnosis of meningococcal invasive infections is often hindered by the early antibiotic treatment, which is highly recommended to improve management and prognosis (Cartwright, 1999). The detection or confirmation of meningococcal infection by nucleic acid amplification has been very successful such that c. 50% of meningococcal infections in the UK for which no isolate is available are now confirmed by PCR (Kaczmarski et al, 1998) and the proportion of nonculture confirmed cases is increasing in several other countries as well.…”

Section: Introductionmentioning

confidence: 99%

Standardized nonculture techniques recommended for European reference laboratories

Taha

Vogel

2007

FEMS Microbiol Rev

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Culture-confirmed diagnosis of meningococcal invasive infections is often hindered by early antibiotic treatment. Nonculture molecular standardized methods are now essential tools for the immediate management of meningococcal infections. The European Monitoring Group on Meningococci (EMGM) recommends the following measures. (1) The implementation of standardized protocols of extraction methods for DNA isolation from clinical specimens for PCR-based identification and genogrouping of Neisseria meningitidis. (2) The use of molecular approaches (sequencing of target genes) for the determination of meningococcal susceptibility to antibiotics, such as sequencing of penA and rpoB genes for susceptibility to penicillin G and rifampicin, respectively. (3) The use of nonculture strain characterization by multilocus sequence typing (MLST) and sequence typing of porA and fetA. These approaches can be implemented either by individual reference laboratories or through collaboration and referral between centres.

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“…Cultured Neisseria meningitidis, when available, would allow the above three actions (culture, antibiogram, serogrouping, serotyping and genotyping) using conventional bacteriological methods. However, early antibiotic treatment is recommended when invasive meningococcal infection is suspected and hence isolation of viable bacteria is often compromised (Cartwright et al, 1992;Cartwright, 1999).…”

Section: Introductionmentioning

confidence: 99%

Quality assessed nonculture techniques for detection and typing of meningococci

Taha

Fox

2007

FEMS Microbiol Rev

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PCR protocols are increasingly used in laboratories worldwide for the diagnosis and confirmation of invasive meningococcal infection. Protocols are now available for the identification of Neisseria meningitidis, for genogrouping, susceptibility to antibiotics and genotyping of the corresponding isolates. The implementation of quality assurance (QA) schemes and standardization of protocols are required. Diagnostic and confirmatory PCRs should perform consistently in clinical and reference microbiology laboratories. General QA schemes address the issues of sample preparation, PCR laboratory environment, equipment and validation of protocols. Moreover, external QA interlaboratory studies are essential. The European Monitoring Group on Meningococci has provided a good forum to conduct such studies through the development and distribution of samples and protocols for nonculture detection and typing of N. meningitidis.

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Management of early meningococcal disease

Cited by 7 publications

References 7 publications

Multilocus Sequence Typing

Multilocus Sequence Typing

Standardized nonculture techniques recommended for European reference laboratories

Quality assessed nonculture techniques for detection and typing of meningococci

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