Detection of Neisseria meningitidis DNA from skin lesion biopsy using real-time PCR: usefulness in the aetiological diagnosis of purpura fulminans.
Intensive Care Med
; 33(7): 1168-1172, 2007 Jul.
Article
en En
| MEDLINE
| ID: mdl-17503017
ABSTRACT
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 MAINRESULTS:
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.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Vasculitis por IgA
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Piel
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ADN Bacteriano
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Reacción en Cadena de la Polimerasa
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Neisseria meningitidis
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Child
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Humans
Idioma:
En
Revista:
Intensive Care Med
Año:
2007
Tipo del documento:
Article
País de afiliación:
Francia