Frequency of Streptococcus pneumoniae infection in patients with suspected meningitis in Imam Reza Hospital of Kermanshah in the west of Iran
,
Abstract
Background and Objectives: Streptococcus pneumoniae is the main causative agent of acute bacterial meningitis in the world. This study aimed to detect pneumoniae infection in cerebrospinal fluid (CSF) samples of patients with suspected meningitis.
Materials and Methods: In this study, 200 CSF samples in patients with suspected meningitis and with negative bacterial cultures were tested. Demographic data of patients and the laboratory analysis of CSF samples were also collected in a questionnaire. Pneumococcal capsular gene spn9802 was examined by real-time PCR technique.
Results: Of 200 CSF samples from patients with the average age of 32.1±25.3 year old, 20 were positive for S. pneumoniae in patients with the average age of 35.05±24.6. The biochemical and cytological analysis of positive samples showed significant changes, including, 39.7 mg/DL protein, 46.2 mg/DL glucose and 1173 white blood cells per microliter of CSF on average.
Conclusion: The results of this study showed the significant pneumococcal infection in culture negative CSF samples. The majority of this infection occurred in middle-aged patients and with a higher incidence rate in the winter. It seems that the traditional methods of cultivation are not sensitive enough to detect this bacterium in CSF .Alternatively, the molecular techniques such a real-time seem to be accurate, sensitive and rapid for the detection of this agent in CSF. The cytological and biochemical findings of CSF can provide valuable clues in the diagnosis of bacterial meningitis.
Rintamäki S, Saukkoriipi A, Salo P, Takala A, Leinonen M. Detection of Streptococcus pneumoniae DNA by using polymerase chain reaction and microwell hybridizationwith Europium-labelled probes. J Microbiol Methods 2002; 50: 313-318.
Greiner O, Day PJR, Bosshard PP, Imeri F, Altwegg M, Nadal D. Quantitative detection of Streptococcus pneumoniae in nasopharyngeal secretions by real-time PCR. J Clin Microbiol 2001; 39: 3129-3134.
Kim DW, Kilgore PE, Kim EJ, Kim SA, Anh DD, Dong BQ, et al. The Enhanced Pneumococcal LAMP Assay: A clinical tool for the diagnosis of meningitis due to Streptococcus pneumoniae. PLoS One 2012; 7: 1-8.
Williams TM, Loman NJ, Ebruke C, Musher DM, Adegbola RA, Pallen MJ, et al. Genome analysis of a highly virulent serotype 1 strain of Streptococcus pneumoniae from West Africa. PLoS One2012; 7(10):1-10.
Cherian T, Lalitha MK, Manonaran A,Thomas K,Yolken RH, Steinhoff MC. PCR-enzyme immunoassay for detection of Streptococcus pneumoniae DNA in cerebrospinal fluid samples from patients with culture- negative meningitis. J Clin Microbiol 1998; 36: 3605-3608.
Weisfelt M, Beek DVD, Spanjaard L, Reitsma JB, Gans JD. Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series. Lancet Neurol 2006; 5: 123-129.
Chavez-Bueno S, McCracken GH Jr. Bacterial meningitis in children. Pediatr Clin North Am 2005; 52: 795-810.
Kastenbauer S, Pfister H-W. Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. J Brain Dis 2003; 126:1015-125.
Tunkel AR, Hartman BJ, Kaplan SL, KaufmanBA,Roos KL, Scheld MW, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004;39:1267-84.
Failace L,Wagner M, Chesky M, Scalco R, Jobim LF.Simultaneous detection of Neisseria meningitidis, Haemophilusinfluenza andStreptococcussp. by polymerase chain reaction for the diagnosis of bacterial meningitis. Arq Neuropsiquiatr 2005; 63: 920-924.
GhotaslouR, Farajnia S, Yeganeh F, Abdoli-Oskouei S, Ahangarzadeh-Rezaee M, Barzegar M. Detection of acute childhood meningitis by PCR, culture and agglutination tests in Tabriz, Iran. Acta Medica Iranica 2012; 50: 192-196.
Kanegaye JT, Soliemanzadeh P, Bradley JS. Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment. JAMA Pediatr 2001; 108: 1169-1174.
Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB. Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR. J Clin Microbiol 2001; 39: 1553-1558.
PanditL, Kumar S, Karunasagar I, Karunasagar I.Diagnosis of partially treated culture-negative bacterial meningitis using 16S rRNA universalprimers and restriction endonuclease digestion. J Med Microbio 2005; 54: 539-542.
Espy MJ, Uni jR, Sloan LM, Buckwalter SP, Jones MF, Vetter EA, et al. Real-Time PCR in Clinical Microbiology: Applications for Routine Laboratory Testing. J ClinMicrobiol Reviews 2006; 19: 165-256.
Saukkoriipi A, Palmu A, Kilpi T, Leinonen M. Real-time quantitative PCR for the detection of treptococcus pneumoniae in the middle ear fluid of children with acute otitis media. Mol Cell Probes 2002; 16: 385-390.
Bryant PA, Li HY, Zaia A, Griffith J, Hogg G, Curtis N, et al. Prospective study of a real-timePCR that is highly sensitive, specific, and clinically useful for diagnosis of meningococcal disease in children. J ClinMicrobiol 2004; 42: 2919-2925.
Suzuki N, Seki M, Nakano Y, Kiyoura Y, Maeno M, Yamashita Y. Discrimination of Streptococcus pneumoniae from viridans groupstreptococci by genomic subtractive hybridization. J Clin Microbiol 2005; 43: 4528-4534.
Sacchi CT, Fukasawa LO, Goncalves MG, Salgado MM, Shutt KA, Carvalhanas TR, et al. Incorporation of real-time PCR into routine public health surveillance of culture negative bacterial meningitis in Sa˜o Paulo, Brazil. PLoS One2011; 6: 1-8.
Kearns AM, Freeman R, Murphy OM, Seiders PR, Steward M, Wheeler J. Rapid PCR-based detection of Streptococcus pneumoniae DNA in cerebrospinal fluid. J Clin Microbiol 1999; 37: 3434.
Reilly BM, Evans AT.Translating clinical research into clinical practice: Impact of using prediction rules to make decisions. Ann Intern Med 2006; 144: 201-209.
Negrini B, Kelleher KJ, Wald ER.Cerebrospinal fluid findings in aseptic versus bacterial meningitis. JAMA Pediatr 2000;105: 316-319.
Ataee RA, Mehrabi-Tavana A, Izadi A, Hosseini SMJ, Ataee MH. Bacterial meningitis: a new risk factor. JRMS 2011;16: 207-210.
Brindusa T, Klara B, Tilea I.Incidence, epidemiology and etiology of acute meningitis in Mures County–an observational study. ARS Medica Tomitana 2012; 3:116-125.
Mosavi-Jarrahi A, Abdolreza Esteghamati A, Asgari F, Heidarnia M, Mousavi-Jarrahi Y, Goya M. Temporal analysis of the incidence of meningitis in the Tehranmetropolitan area, 1999-2005. Population Health Metrics 2009; 7: 1-7.
Bahador M, Amini M, Bahador M. Common cause and cerebrospinal fluid changes of acute bacterial meningitis. IJP 2009; 4 :75-79.
Thomas JD, Hatcher CP, Satterfield DA, Theodore MJ, Bach MC, Linscott KB, et al. SodC-Based Real-Time PCR for Detection of Neisseria Meningitidis. PLoS One2011;6: 1-8.
Mandell, Douglas, Bennett’s (2010). Principles and practice of infectious iseases.7thedChurchill Livingstone Elsevier.
| Files | ||
| Issue | Vol 7 No 1 (2015) | |
| Section | Original Article(s) | |
| Keywords | ||
| Culture-negative meningitis real-time PCR Streptococcus pneumoniae | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
