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01.07.2007 | Pediatric Original

Detection of Neisseria meningitidis DNA from skin lesion biopsy using real-time PCR: usefulness in the aetiological diagnosis of purpura fulminans

verfasst von: Pierre Staquet, Ludovic Lemee, Eva Verdier, Guy Bonmarchand, Vincent Laudenbach, Christine Michel, Jean-Francois Lemeland, Stephane Marret, Thierry Blanc

Erschienen in: Intensive Care Medicine | Ausgabe 7/2007

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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 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.

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Titel: Detection of Neisseria meningitidis DNA from skin lesion biopsy using real-time PCR: usefulness in the aetiological diagnosis of purpura fulminans
verfasst von: Pierre Staquet
Ludovic Lemee
Eva Verdier
Guy Bonmarchand
Vincent Laudenbach
Christine Michel
Jean-Francois Lemeland
Stephane Marret
Thierry Blanc
Publikationsdatum: 01.07.2007
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 7/2007
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0667-2

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Detection of Neisseria meningitidis DNA from skin lesion biopsy using real-time PCR: usefulness in the aetiological diagnosis of purpura fulminans