Molecular diagnosis of bacterial meningitis in Burkina Faso

Study Objectives. The aim of this pilot study was to evaluate the use of real-time polymerase chain reaction (RT-PCR) in the diagnosis of bacterial meningitis in Burkina Faso. Methodology. This retrospective study reviewed the analyses of specimens collected from April 2009 through February 2010. DNA was extracted from cerebrospinal fluid (CSF) from patients with suspected meningitis from different health districts in Burkina Faso and analyzed with RT-PCR. Many patients were also tested with traditional diagnostic methods for meningitis: culture and serology (latex agglutination test). Results. The study included 171 patients hospitalized in 8 health districts. Bacterial DNA for germs causing purulent meningitis was identified in 108/171 patients (63%); corresponding percentages for culture and latex were 60% (56/93) and 77% (66/86), respectively. All three methods found that NmA and Spn were the two main bacteria responsible for purulent meningitis in our cohort: with real time PCR, NmA = 59.3% and Spn = 34.3%), culture (NmA = 78.6% and Spn = 17.8%) or latex (NmA = 77.3% and Spn = 21.2%). Real-time PCR improved the sensitivity and the specificity of the diagnosis of the germs involved in this study and allowed the detection of the serogroups NmY and NmW135, which could not be detected by culture or latex agglutination test. RT-PCR permitted the detection and the characterization of bacteria responsible for purulent meningitis from CSF-contaminated cultures that could not otherwise be detected.