Document Detail


Detection of Neisseria meningitidis DNA from skin lesion biopsy using real-time PCR: usefulness in the aetiological diagnosis of purpura fulminans.
MedLine Citation:
PMID:  17503017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The present study evaluated the usefulness of a real-time polymerase chain reaction (rtPCR) assay for the detection of Neisseria meningitidis (Nm) and genogrouping on skin lesion biopsies in patients with purpura fulminans (PF). DESIGN: Retrospective single-centre study. SETTING: Adult and paediatric intensive care units at the University Hospital of Rouen. PATIENTS: All patients admitted between January 2000 and January 2006, with a final diagnosis of PF and for which a skin biopsy and blood cultures were performed, were included. INTERVENTIONS: Skin biopsy and blood cultures were used for culture and rtPCR. MEASUREMENTS AND MAIN RESULTS: Thirty-four patients fulfilled the criteria (27 children and 7 adults). Nm rtPCR performed on skin biopsy was positive in 100% (34/34) of cases, compared with only 14.7% (5/34) for skin culture (p=0.0001). rtPCR genogrouping on skin biopsy was positive in 58.8% (20/34) of the cases compared with 14.7% (5/34) for skin culture (p=0.0013). For patients (n=17) in whom rtPCR was performed both on blood and skin biopsy, skin biopsy gave a significantly higher rate of Nm detection [100% (17/17) vs. 58.8% (10/17); p=0.023] and genogroup characterisation [76.5% (13/17) vs. 35.3% (6/17); p=0.045] than blood. We encountered no specimen with culture-positive and rtPCR-negative results (negative predictive value of rtPCR 100%). CONCLUSION: In suspected PF cases, skin biopsy is more reliable to identify Nm and its genogroup than blood or, probably, CSF, especially when PCR methods are used. This could help the implementation of public health interventions, especially concerning a vaccination policy.
Authors:
Pierre Staquet; Ludovic Lemee; Eva Verdier; Guy Bonmarchand; Vincent Laudenbach; Christine Michel; Jean-Francois Lemeland; Stephane Marret; Thierry Blanc
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Publication Detail:
Type:  Journal Article     Date:  2007-05-15
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-05     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1168-72     Citation Subset:  IM    
Affiliation:
Service de Pédiatrie Néonatale et Réanimation, Centre Hospitalier Universitaire de Rouen, 1, Rue de Germont, 76031, Rouen Cedex, France. pierre.staquet@chu-rouen.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Blood / microbiology
Child
DNA, Bacterial / isolation & purification*
Humans
Intensive Care Units
Intensive Care Units, Pediatric
Neisseria meningitidis / genetics,  isolation & purification*
Polymerase Chain Reaction / methods*
Purpura, Schoenlein-Henoch / microbiology*
Retrospective Studies
Skin / chemistry,  microbiology*
Chemical
Reg. No./Substance:
0/DNA, Bacterial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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