Mothershed Elizabeth A, Sacchi Claudio T, Whitney Anne M, Barnett Gwen A, Ajello Gloria W, Schmink Susanna, Mayer Leonard W, Phelan Maureen, Taylor Thomas H, Bernhardt Scott A, Rosenstein Nancy E, Popovic Tanja
Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Clin Microbiol. 2004 Jan;42(1):320-8. doi: 10.1128/JCM.42.1.320-328.2004.
Neisseria meningitidis is a leading cause of bacterial meningitis and septicemia in children and young adults in the United States. Rapid and reliable identification of N. meningitidis serogroups is crucial for judicious and expedient response to cases of meningococcal disease, including decisions about vaccination campaigns. From 1997 to 2002, 1,298 N. meningitidis isolates, collected in the United States through the Active Bacterial Core surveillance (ABCs), were tested by slide agglutination serogrouping (SASG) at both the ABCs sites and the Centers for Disease Control and Prevention (CDC). For over 95% of isolates, SASG results were concordant, while discrepant results were reported for 58 isolates. To resolve these discrepancies, we repeated the SASG in a blinded fashion and employed ctrA and six serogroup-specific PCR assays (SGS-PCR) to determine the genetic capsule type. Seventy-eight percent of discrepancies were resolved, since results of the SGS-PCR and SASG blinded study agreed with each other and confirmed the SASG result at either state health laboratories or CDC. This study demonstrated the ability of SGS-PCR to efficiently resolve SASG discrepancies and identified the main cause of the discrepancies as overreporting of these isolates as nongroupable. It also reemphasized the importance of adherence to quality assurance procedures when performing SASG and prompted prospective monitoring for SASG discrepancies involving isolates collected through ABCs in the United States.
脑膜炎奈瑟菌是美国儿童和年轻人细菌性脑膜炎和败血症的主要病因。快速可靠地鉴定脑膜炎奈瑟菌血清群对于明智且迅速地应对脑膜炎球菌病病例至关重要，包括有关疫苗接种活动的决策。1997年至2002年期间，通过主动细菌核心监测（ABCs）在美国收集的1298株脑膜炎奈瑟菌分离株，在ABCs站点和疾病控制与预防中心（CDC）均通过玻片凝集血清群鉴定法（SASG）进行了检测。对于超过95%的分离株，SASG结果一致，而有58株分离株报告了不一致的结果。为了解决这些差异，我们以盲法重复了SASG，并采用ctrA和六种血清群特异性PCR检测法（SGS-PCR）来确定基因荚膜类型。78%的差异得到了解决，因为SGS-PCR和SASG盲法研究的结果相互一致，并在州卫生实验室或CDC确认了SASG结果。这项研究证明了SGS-PCR有效解决SASG差异的能力，并确定差异的主要原因是将这些分离株误报为不可分组。它还再次强调了在进行SASG时遵守质量保证程序的重要性，并促使对涉及通过美国ABCs收集的分离株的SASG差异进行前瞻性监测。
