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Efficacité d’une technique de réaction de polymérisation en chaîne (seminested et multiplex) pour l’identification des trois principales espèces bactériennes responsables de méningites au Burkina Faso

Université de Ouagadougou 3 BP 7021 Ouagadougou 03 Burkina Faso; ministère de la Santé Direction des laboratoires Ouagadougou Burkina Faso; CHU pédiatrique Charles-De-Gaulle Ouagadougou Burkina Faso
Bulletin de la Société de pathologie exotique 103(1):8-13. DOI: 10.1007/s13149-009-0003-x

ABSTRACT Une étude prospective de neuf mois (1er août 2006 au 30 avril 2007) a été réalisée au Multi Disease Surveillance Centre (MDSC) de Ouagadougou sur 214 échantillons
de liquide céphalorachidien (LCR) provenant de cas suspects de méningites bactériennes. L’objectif de l’étude était d’évaluer
la performance d’une technique de détection simultanée de Neisseria meningitidis, de Streptoccocus sp. et de Haemophilus influenzae par une polymerase chain reaction (PCR) en multiplex, utilisant une stratégie de seminested. Sur les 214 échantillons analysés par PCR et par culture, les
taux globaux de confirmation des cas suspects de méningites étaient de 64 % par la PCR et 40,1 % par la culture bactérienne
(p = 2 × 10−6). En prenant la culture comme référence, la technique PCRa, de façon globale, une sensibilité (Se) de 98,8 % et une spécificité
(Sp) de 59,4 %. La Se de la PCR était respectivement de 100, 97,3 et 100 % pour N. meningitidis, pour Streptoccocus sp. et pour H. influenzae, avec des Sp respectives de 70, 93,2 et 97,2 %. En conclusion, la technique de seminested PCR est une technique sensible
et peut être implémentée dans les laboratoires de référence dans le but d’une surveillance microbiologique plus exhaustive
des méningites bactériennes.

A prospective study (from August 2006 to April 2007) was carried out with 214 cerebrospinal fluid samples with suspicion of
bacterial meningitis. The aim of the study was to assess the effectiveness of the simultaneous detection of Neisseria meningitidis, Streptococcus sp. and Haemophilus influenzae using seminested polymerase chain reaction strategy. Among the 214 samples tested by both PCR and culture, the overall confirmation
rate was 64% for PCR and 40.1% for culture (P = 2 × 10−6). Taking culture method as the standard reference, the overall sensitivity of PCR was 98.8% and specificity, 59.4%. The sensitivity
of PCR was 100, 97.3 and 100% respectively for N. meningitidis, Streptococcus sp. and H. influenzae with respective specificities of 70, 93.2 and 97.2%. In conclusion, the seminested PCR strategy is a sensitive method and
it can be implemented in the reference public health laboratories for an exhaustive microbiological surveillance of bacterial
meningitis.

Mots clés
Polymerase chain reaction (PCR)-Méningite bactérienne-
Neisseria meningitidis
-
Streptococcus sp.
-
Haemophilus influenzae
-Boussé-Ouagadougou-Burkina Faso-Afrique intertropicale
KeywordsPolymerase chain reaction (PCR)-Bacterial meningitis-
Neisseria meningitidis
-
Streptococcus sp.
-
Haemophilus influenzae
-Boussé-Ouagadougou-Burkina Faso-Sub Saharan Africa

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    ABSTRACT: Burkina Faso is a sub-saharan African country completely included in the meningococcal meningitis belt. The western part of the country suffered from many meningococcal A epidemics, in spite of reactive collective campaigns with polysaccharide A vaccine. On 6th December 2010, Burkina Faso was the first African country to conduct a collective vaccination campaign of all the 1-29 years old population with a new conjugated meningococcal Avaccine (MenAfriVac™). Before this campaign, in Western Burkina (4,064,928 inhabitants, 27.5% of total population), a rehearsal of the staff of all peripheral medical laboratories has been conducted, with delivery of laboratory equipment, reactants, and possibility to transfer CSF specimens at the central level to confirm bacteriologic species in cause by latex, culture and PCR analysis. For this campaign, an administrative coverage of 100.3% was reached. A nearly complete disappearance of meningitis due to meningococcus A was recorded, but an increase of cases due to meningococcus X, W135. With the increase of quality of surveillance, and MenAfriVac™ vaccination showed its beneficial effect on meningococcus A meningitis. If we want however to impact on the number of recorded acute bacteriological meningitis, we will have to use multi-antigenic, if possible conjugated, meningococcal vaccines against locally circulating meningococcal species, the number of pneumococcal meningitis being contained by the recent inclusion in EPI of a 13-valent conjugated pneumococcal vaccine.
    Bulletin de la Société de pathologie exotique 01/2014;

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