Pardo F, Juncal R, Rajo C, Pérez del Molino M L
Servicio de Microbiología, Hospital General de Galicia, Complejo Hospitalario Universitario de Santiago de Compostela.
Enferm Infecc Microbiol Clin. 1999 Feb;17(2):74-7.
The aim of this work was to evaluate the applicability of polymerase chain reaction (PCR) in the microbiological diagnostic of meningococcal meningitis as compared with the conventional methods (Gram stain and culture).
One hundred and fifteen cerebrospinalis fluid samples from 115 patients with suspicious symptoms of meningitis were studied. 47 of them belonged to patients suspicious for meningococcal disease; 28 to patients with bacterial meningitis of other infectious etiologies; 10 to patients with meningitis showing lymphocytic pleocytosis and 30 to patients with an unconfirmed meningitis. The cerebrospinalis fluid samples were processed for culture by standard procedures and by PCR according to the method described by Newcombe et al for peripheral blood samples.
Thirty five out of 39 patients suspicious of meningococcal meningitis were microbiologically confirmed, being 22 culture and PCR positive, 3 microscopically and PCR positive, 1 only microscopically positive, and 9 positive only by PCR. By using PCR methodology, the number of confirmed diagnostics of meningococcal meningitis increased in a 23% as compared to those obtained by microscopic observation and culture. Sensitivity, specificity, predictive positive value and predictive negative value were 87.1, 98.7, 97.1 and 94.1 respectively for the PCR method.
Our results indicate that PCR can be used on routine basis as a complementary technique to the standard laboratory procedures for diagnosis of meningococcal meningitis.
本研究旨在评估聚合酶链反应（PCR）在脑膜炎球菌性脑膜炎微生物诊断中的适用性，并与传统方法（革兰氏染色和培养）进行比较。
对115例有脑膜炎可疑症状患者的115份脑脊液样本进行研究。其中47例为疑似脑膜炎球菌病患者；28例为其他感染病因引起的细菌性脑膜炎患者；10例为淋巴细胞性脑膜炎患者；30例为未确诊的脑膜炎患者。脑脊液样本按标准程序进行培养，并根据Newcombe等人描述的外周血样本方法进行PCR检测。
39例疑似脑膜炎球菌性脑膜炎患者中，35例经微生物学确诊，其中22例培养和PCR均阳性，3例显微镜检查和PCR阳性，1例仅显微镜检查阳性，9例仅PCR阳性。与显微镜观察和培养相比，采用PCR方法确诊的脑膜炎球菌性脑膜炎病例数增加了23%。PCR方法的敏感性、特异性、阳性预测值和阴性预测值分别为87.1、98.7、97.1和94.1。
我们的结果表明，PCR可作为诊断脑膜炎球菌性脑膜炎的标准实验室程序的补充技术常规使用。
