Afifi S, Karsany M S, Wasfy M, Pimentel G, Marfin A, Hajjeh R
U. S. Naval Medical Research Unit, New York, USA.
Eur J Clin Microbiol Infect Dis. 2009 May;28(5):429-35. doi: 10.1007/s10096-008-0643-y. Epub 2008 Nov 12.
To determine the burden of bacterial meningitis and characterize its epidemiology, a laboratory-based surveillance was established in five hospitals in Sudan. Hospital personnel were trained in basic surveillance and bacteriology techniques. Positive cerebrospinal fluid (CSF) cultures were confirmed at Sudan National Laboratories and U.S. Naval Medical Research Unit No. 3. Additionally, 126 frozen CSF samples from culture-negative meningitis cases were tested by polymerase chain reaction (PCR). Of 1,830 suspected meningitis cases enrolled, 75% were less than 5 years old and 63% were males. Of these, 149 (8%) were culture-confirmed, including 121 (81%) Neisseria meningitidis; 18 (12%) Streptococcus pneumoniae, and 10 (7%) Haemophilus influenzae. Of 440 turbid specimens, 132 (30%) were culture-positive. Of the 126 samples from culture-negative meningitis cases that were tested, only 18 (14%) were classified as turbid on gross examination, yet 63 (50%) were positive by PCR. This study suggests that PCR may be useful to more accurately define the burden of disease in epidemic setting. Maintaining laboratory-based surveillance allows evidence-based decision-making and helps monitor the impact of new vaccines introduction.
为确定细菌性脑膜炎的负担并描述其流行病学特征，在苏丹的五家医院建立了基于实验室的监测。医院工作人员接受了基本监测和细菌学技术培训。脑脊液（CSF）培养阳性结果在苏丹国家实验室和美国海军医学研究第三分队得到确认。此外，对126例培养阴性脑膜炎病例的冷冻脑脊液样本进行了聚合酶链反应（PCR）检测。在纳入的1830例疑似脑膜炎病例中，75%年龄小于5岁，63%为男性。其中，149例（8%）培养确诊，包括121例（81%）脑膜炎奈瑟菌；18例（12%）肺炎链球菌，10例（7%）流感嗜血杆菌。在440份浑浊标本中，132份（30%）培养阳性。在检测的126例培养阴性脑膜炎病例的样本中，只有18份（14%）在肉眼检查时被分类为浑浊，但63份（50%）PCR检测呈阳性。这项研究表明，PCR可能有助于更准确地确定流行环境中疾病的负担。维持基于实验室的监测有助于基于证据的决策，并有助于监测新疫苗引入的影响。
