A polymerase chain reaction-enzyme immunoassay for diagnosis of pneumococcal meningitis in children and adults.

BACKGROUND AND

OBJECTIVES

meningitis due to Streptococcus pneumoniae is common among children and adults. In this study a polymerase chain reaction (PCR) for diagnosis of pneumococcal meningitis was evaluated prospectively.

METHODS

a total of 61 cerebrospinal fluid specimens were included prospectively using defined inclusion and exclusion criteria. These samples were studied by PCR-EIA and results compared with conventional microbiological procedures and antigen detection techniques. Primers were used against the conserved region of the pneumococcal autolysin gene and the amplified product was labelled using the digoxigenin-labelled dUTP. The product was detected by an enzyme immuno assay (EIA) after hybridization with a biotin labelled probe.

RESULTS

a total of 15 specimens were positive for S.pneumoniae by one or more methods used. Culture for S.pneumoniae was positive in 13 specimens, PCR-EIA was positive in 11 of these specimens with an additional pickup of 2 specimens and latex agglutination (LA) positive only in one.

INTERPRETATION AND

CONCLUSIONS

sensitivity and specificity of 84.6 and 95.8 per cent respectively were observed with PCR-EIA. It seems to be a good tool for the diagnosis of pneumococcal meningitis especially in cases of partially treated pyogenic meningitis.