ArticleJournal of clinical microbiology2004
Prospective study of a real-time PCR that is highly sensitive, specific, and clinically useful for diagnosis of meningococcal disease in children.
Article in Journal of clinical microbiology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- Meningococcal meningitis in India: An expert consensus on use of MCVs.Human vaccines & immunotherapeutics · 2026Pooled it
- A Ten-Year Retrospective Review of Medical Records of Patients Admitted with Meningitis or Encephalitis at Five Hospitals in the United States Highlights the Potential for Under-Ascertainment of Invasive Meningococcal Disease.Pathogens (Basel, Switzerland) · 2025Article
- Current methods in the diagnosis of invasive meningococcal disease.Frontiers in pediatrics · 2025Review
- Article
- Metagenomic data from cerebrospinal fluid permits tracing the origin and spread of Neisseria meningitidis CC4821 in China.Communications biology · 2022Article
- Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases.Frontiers in neurology · 2021Review
- Fatal meningococcal meningitis in a 2-year-old child: A case report.World journal of clinical cases · 2019Article
- Diagnosis of bacterial meningitis in Ghana: Polymerase chain reaction versus latex agglutination methods.PloS one · 2019Observational
- Global Meningococcal Initiative: guidelines for diagnosis and confirmation of invasive meningococcal disease.Epidemiology and infection · 2016Review
- Invasive meningococcal disease in the 21st century—an update for the clinician.Current neurology and neuroscience reports · 2015Review
- Frequency of Streptococcus pneumoniae infection in patients with suspected meningitis in Imam Reza Hospital of Kermanshah in the west of Iran.Iranian journal of microbiology · 2015Article
- Article
- Identification of etiological agents by LPA and PCR in childhood meningitis.Pakistan journal of medical sciences · 2013Article
- Accuracy of real-time PCR, Gram stain and culture for Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae meningitis diagnosis.BMC infectious diseases · 2013Article
- Enteroviral meningitis does not exclude concurrent bacterial meningitis.Journal of clinical microbiology · 2011Article
- Evaluation of a real-time polymerase chain reaction assay for the diagnosis of pneumococcal and meningococcal meningitis in a tertiary care hospital.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2007Article
- Real-time polymerase chain reaction for the rapid detection of group B streptococcal colonization in neonates.Pediatrics · 2006Article
- Mutations in folP associated with elevated sulfonamide MICs for Neisseria meningitidis clinical isolates from five continents.Antimicrobial agents and chemotherapy · 2005Article
- Comparison of PCR-based methods for the simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in clinical samples.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Due to the early administration of antibiotics, meningococcal disease is increasingly difficult to diagnose by culturing. Laboratory studies have shown PCR to be sensitive and specific, but there have been few clinical studies. The objectives of this study were to determine the diagnostic accuracy and clinical usefulness of meningococcal PCR through a prospective comparison of real-time PCR, nested PCR, and standard culturing of blood and cerebrospinal fluid (CSF). The setting was a tertiary-care pediatric hospital in Australia, and the participants were 118 children admitted with possible septicemia or meningitis. The main outcome measures-sensitivity, specificity, and positive and negative predictive values-were compared to a "gold standard " fulfilling clinical and laboratory criteria. For 24 cases of meningococcal disease diagnosed by the gold standard, culturing of blood or CSF was positive for 15 (63%), nested PCR was positive for 21 (88%), and real-time PCR was positive for 23 (96%). The sensitivity, specificity, and positive and negative predictive values of real-time PCR (the most sensitive test) for all specimens were, respectively, 96% (95% confidence interval, 79 to 99%), 100% (95% confidence interval, 96 to 100%), 100% (95% confidence interval, 85 to 100%), and 99% (95% confidence interval, 94 to 100%). Of 54 patients with suspected meningococcal disease at admission, 23 had positive PCR results. Only one PCR specimen was positive in a patient thought unlikely to have meningococcal disease at admission. Blood PCR remained positive for 33% of patients tested at up to 72 h. Real-time PCR has high positive and negative predictive values in this clinical setting, with better confirmation of cases than nested PCR. Targeting patients for PCR based on admission criteria appears to be practical, and the test may remain useful for several days after the start of antibiotic administration.
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