Diagnosis of bacterial meningitis: real-time PCR saves time

Training on the diagnosis of bacterial meningitis by real-time PCR, as part of the ASID research project in collaboration with CDC Atlanta, was held from 18th to 23rd February 2019 at the Centre Pasteur du Cameroun.

Building laboratory capacity for the diagnosis and surveillance of bacterial meningitis in the sub-Saharan meningitis belt was the objective of this training, which enabled participants to be able to use diagnostic tools that are robust, rapid, reliable and allow them to respond as quickly and effectively as possible when an epidemic case alert is issued or even for case-by-case surveillance. Supervised by Dr Deghmane Ala Eddine, Research Officer in the Invasive Bacterial Infections Unit, Deputy Director of the National Reference Centre (NRC) for Meningocococci and Haemophilus influenzae and WHO Collaborating Centre for Bacterial Meningitis, assisted by Mrs Hong Eva, Research Engineer at the Pasteur Institute in Paris, and Miss Chehboub Sara, Senior Research Technician at the Pasteur Institute in Paris, this training was conducted in 2 phases: the first, which was intended to be theoretical, was to provide training on diagnostic tools, and the second, more practical, allowed participants to better assimilate the various diagnostic tools through practice. The laboratory technicians of CPC Yaoundé and Garoua, as well as the head of the Hygiene and Microbiology Environment Department, took part in this training.

In case of suspected meningitis, the existence of a meningitis infection should be supported by a lumbar puncture. This is an impressive and unpleasant, but not very dangerous, test that involves taking a small amount of cerebrospinal fluid (CSF) between two vertebrae using a thin needle. This fluid surrounding the brain will be examined by the PCR technique in real time to see if it contains germs and if its composition and pressure level are modified. As soon as the results are available, clinicians can take charge of the patient for positive tests or recommend prevention to the Centre Pasteur du Cameroun, which offers a quadrivalent vaccine for life.

Before this method, meningitis was diagnosed by culture, although it is subject to several limitations, including time. Because the sample had to be sent within an hour, which sometimes distorted the results of the diagnosis. Therefore, the implementation of real-time PCR will allow that even if the sample is degraded, the clinician will be able to identify the etiological agent of the disease. This technique has two major advantages. The first is that it is more sensitive, faster and will detect the germ despite the low amount of DNA, and the second is that it should improve the diagnosis of meningitis, and therefore have a significant impact on the surveillance of bacterial meningitis in Cameroon.

For the time being, the Centre Pasteur du Cameroun is the only one to implement this new technique, and the training has helped to strengthen its expertise as the national reference laboratory for bacterial meningitis in Cameroon.

This article was first published by the Centre Pasteur du Cameroun and translated in English by Afriscitech.


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