Abstract: To improve the epidemiologic surveillance of bacterial meningitis in
Burkina Faso, cerebrospinal fluid samples from suspected acute bacterial
meningitis in the Department of Pediatrics at Centre Hospitalier Universitaire
Souro Sanou (CHU-SS), Bobo Dioulasso were tested by polymerase chain reaction
(PCR) assay and results were compared to standard bacteriologic methods. The
study was conducted over 13 months (March 2002 until March 2003) and included
170 suspected cases of meningitis in which lumbar punctures were performed.
Cerebrospinal fluid samples were cultured on selective media and bacterial
isolates were identified in 60 cases as follows; 56% Neisseria
meningitidis, 22% Streptococcus pneumoniae, and 22%
Haemophilus influenzae type b. Etiologic agents were detected by PCR in 77
cases as follows; 53% N. meningitidis, 21% S. pneumoniae, and
26% H. influenzae type b. Of the 162 samples evaluated by Gram stain,
64 (39.5%) were positive compared to 77 (45.5%) of the same samples that
tested positive by PCR. Of the 88 samples selected for bacterial culture, 60
(68.2%) or 37% of the 162 total samples were positive. In the latex
agglutination performed on 83 samples, 74 (89.2%), or 45.7% of the 162
total were positive. Sensitivity, specificity, positive predictive value, and
negative predictive value of PCR measured against the results of standard
cultures of Streptococcus were 76.92%, 97.3%, 83.33% and 96%
respectively; for H. influenzae type b, values were 84.6%,
89.18%, 57.89% and 97.05%, respectively and for N. meningitidis,
values were 100%, 86.8%, 82.92%, and 100%, respectively. These
results suggest that PCR is a useful technique for the evaluation of bacterial
meningitis, when used in conjunction with bacterial cultures.
