A polymerase chain reaction-enzyme immunoassay for diagnosis of pneumococcal meningitis in children & adults

Background & objectives: Meningitis due to Streptococcus pneumoniae is comm on among children and adults. In this study a polymerase chain reaction (PC R) for diagnosis of pneumococcal meningitis was evaluated prospectively. Methods: A total of 61 cerebrospinal fluid specimens were included prospect ively using defined inclusion and exclusion criteria. These samples were st udied by PCR-EIA and results compared with conventional microbiological pro cedures and antigen detection techniques. Primers were used against the con served region of the pneumococcal autolysin gene and the amplified product was labelled using the digoxigenin-labelled dUTP, The product was detected by an enzyme immune assay (EIA) after hybridization with a biotin labelled probe. Results: A total of 15 specimens were positive for S.pneumoniae by one or m ore methods used. Culture for S.pneumoniae was positive in 13 specimens, PC R-EIA was positive in Ii of these specimens with an additional pickup of 2 specimens which were PCR-EIA positive for S. pneumoniae when culture was ne gative for both specimens and latex agglutination (LA) positive only in one . Interpretation & conclusions: Sensitivity and specificity of 84.6 and 95.8 per cent respectively were observed with PCR-EIA, It seems to be a good too l for the diagnosis of pneumococcal meningitis especially in cases of parti ally treated pyogenic meningitis.