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Journal of Clinical Microbiology, August 1998, p. 2205-2209, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Diagnosis of Meningococcal Meningitis by Broad-Range Bacterial PCR with Cerebrospinal Fluid

Pirkko Kotilainen,1,2,* Jari Jalava,3 Olli Meurman,4 Olli-Pekka Lehtonen,4 Esa Rintala,1 Olli-Pekka Seppälä,1 Erkki Eerola,3 and Simo Nikkari3,dagger

Department of Medicine,1 and Department of Clinical Microbiology,4 Turku University Central Hospital, Antimicrobial Research Laboratory, National Public Health Institute,2 and Department of Medical Microbiology, Turku University,3 20520 Turku, Finland

Received 22 September 1997/Returned for modification 16 January 1998/Accepted 27 April 1998

We used broad-range bacterial PCR combined with DNA sequencing to examine prospectively cerebrospinal fluid (CSF) samples from patients with suspected meningitis. Fifty-six CSF samples from 46 patients were studied during the year 1995. Genes coding for bacterial 16S and/or 23S rRNA genes could be amplified from the CSF samples from five patients with a clinical picture consistent with acute bacterial meningitis. For these patients, the sequenced PCR product shared 98.3 to 100% homology with the Neisseria meningitidis sequence. For one patient, the diagnosis was initially made by PCR alone. Of the remaining 51 CSF samples, for 50 (98.0%) samples the negative PCR findings were in accordance with the negative findings by bacterial culture and Gram staining, as well as with the eventual clinical diagnosis for the patient. However, the PCR test failed to detect the bacterial rRNA gene in one CSF sample, the culture of which yielded Listeria monocytogenes. These results invite new research efforts to be focused on the application of PCR with broad-range bacterial primers to improve the etiologic diagnosis of bacterial meningitis. In a clinical setting, Gram staining and bacterial culture still remain the cornerstones of diagnosis.

* Corresponding author. Mailing address: Department of Medicine, Turku University Central Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland. Phone: 358 2 2611611. Fax: 358 2 2612030. E-mail: pirkko.kotilainen{at}utu.fi.

dagger Present address: Department of Microbiology and Immunology, Stanford University School of Medicine, VA Palo Alto Health Care System 154T, Palo Alto, CA 94304.

Journal of Clinical Microbiology, August 1998, p. 2205-2209, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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