In the UK the increasing use of pre-admission parenteral antibiotic therapy in meningococcal
disease has lessened the value of routine cultures as a tool to confirm diagnosis, and laboratory
confirmation of invasive meningococcal infection is achieved increasingly by non-culture,
nucleic acid amplification methods. The purpose of this study was to evaluate a DNA
extraction and meningococcal-specific DNA amplification methodology for detection of
meningococci from oropharyngeal swabs.
One hundred and six swabs from suspected or confirmed cases of meningococcal disease, and
94 swabs from contacts of meningococcal disease cases were examined. Of laboratory-confirmed
cases, 38/65 (58·5%) yielded a positive oropharyngeal swab PCR result and 5/24
(20·8%) swabs from suspected but laboratory-unconfirmed cases were PCR positive. No
significant differences in PCR positivity rates were found between the types of swab transport
systems utilized, but transport time to the testing laboratory was found to affect PCR positivity
(P < 0·05).
Application of meningococcus-specific PCR to oropharyngeal swabs, in addition to routine
culture of swabs, can provide valuable epidemiological information as well as case confirmation
for contact management. PCR amplification of meningococcal PCR from oropharyngeal swabs
will also increase the ascertainment in swabbing surveys carried out as part of meningococcal
disease outbreak investigation and management.