Identification of Neisseria Meningitidis in Patients with Suspected Meningitis: a Study in Imam Reza Hospital, Kermanshah City, Iran, 2013

Neisseria meningitidis is bacteria fastidious, and the main causes of meningitis and acute sepsis. Appropriate treatment depends on accurate and timely diagnosis. This study aimed to identify Neisseria meningitidis infection in samples of cerebrospinal fluid (CSF) in patients with suspected meningitis.
In this study, 198 samples of cerebrospinal fluid of patients with suspected bacterial meningitis were assessed using real-time polymerase chain reaction (real-time PCR) targeted with specific primers prepared from meningococcal ctrA gene with the length of 110 bp. In addition, the data of patients and analysis of cerebrospinal fluid were collected.
The mean age of the studied patients was 32.1 ± 25.3 year. Totally, the samples of 7 patients (3.5%) with the mean age of 44.0 ± 28.2 years were positive for meningococcal infectioun with the mean protein and glucose levels of 39.86 and 41.86 mg/dl, respectively. In positive cases, the mean number of white blood cells was 5009 with the mean polymorphonuclear (PMN) value was 76.5%.
In this study, most of the positive cases were middle-aged men 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 cerebrospinal fluid. Alternatively, the molecular techniques such as real-time polymerase chain reaction seem to be accurate, sensitive and rapid for the detection of meningococcus in cerebrospinal fluid. The cytological and biochemical findings of cerebrospinal fluid can provide valuable clues in the diagnosis of bacterial meningitis.