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2019, Cilt 49, Sayı 4, Sayfa(lar) 191-196
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Determination of Bacterial Meningitis Agents by Culture and PCR in Patients Diagnosed with Meningitis
Sezer Toprak1, Kübra Can2, Reyhan Çalışkan3, Gönül Şengöz4, Zafer Habip5 Edip Tokuç2, Mehmet Demirci6, Zeynep Taner2, Müzeyyen Mamal Torun7, Bekir Sami Kocazeybek2, Hrisi Bahar Tokman2
1Yedikule Göğüs Hastalıkları Hastanesi, Mikrobiyoloji Laboratuvarı, İstanbul
2İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İstanbul
3İstanbul Aydın Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İstanbul
4Haseki Eğitim ve Araştırma Hastanesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, İstanbul
5İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İstanbul 6Beykent Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İstanbul
7Bahçeşehir Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İstanbul
Keywords: Bacterial meningitis, community and hospital, adult patient

Objective: We aimed to determine the community-acquired bacterial meningitis and nosocomial bacterial meningitis cases in patients diagnosed with meningitis in our hospital. At the same time we aimed to determine in these cases whether multiplex PCR was advantageous in the detection of Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Group B Streptococcus and Listeria monocytogenes compared to culture.

Methods: Our study was performed with cerebrospinal fluid (CSF) samples of 100 adult patients admitted to Cerrahpaşa Medical Faculty between February 2012 and June 2013 and were diagnosed as meningitis. Samples were taken in two tubes. From the first tube, macroscopic examination of the CSF sample was performed, followed by inoculation, cell counting, Gram staining and direct antigen determination. The sample in the 2nd tube was inoculated in a blood culture flask (BD Bactec FX) and was incubated at 37°C. Bacteria were identified using standard clinical microbiology methods and further identification was made with API (BioMérieux, France) kits. Additionally, Seeplex Meningitis-B Ace Detection kit (Seegene Inc., Korea) was used for molecular detection. The presence of more than 200 leukocytes in the CSF samples and the predominance of PNL supported the diagnosis of meningitis.

Results: Bacteria were detected in eight of 66 clear CSF samples (12.1%), in four of 12 xanthochromic CSF samples (30%) and in nine of 22 blurred CSF samples (40.9%). In CSF samples of cases with nosocomial meningitis, the most common bacteria were methicillin-resistant coagulase-negative staphylococci (n=6, 30%), and Klebsiella spp. (n=4, 20%). In one patient with community-acquired meningitis S. pneumoniae was isolated by multiplex PCR.

Conclusion: Determination of bacteria causing community-acquired meningitis should not be based solely on the culture method, the advantages of PCR method should be utilized.


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