RESUMEN

Staphylococcus aureus clonal complex 398 (CC398) is associated with disease in humans and livestock, and its origins and transmission have generated considerable interest. We performed a time-scaled phylogenetic analysis of CC398, including sequenced isolates from the United Kingdom (Scotland), along with publicly available genomes. Using state-of-the-art methods for mapping traits onto phylogenies, we quantified transitions between host species to identify sink and source populations for CC398 and employed a novel approach to investigate the gain and loss of antibiotic resistance in CC398 over time. We identified distinct human- and livestock-associated CC398 clades and observed multiple transmissions of CC398 from livestock to humans and between countries, lending quantitative support to previous reports. Of note, we identified a subclade within the livestock-associated clade comprised of isolates from hospital environments and newborn babies, suggesting that livestock-associated CC398 is capable of onward transmission in hospitals. In addition, our analysis revealed significant differences in the dynamics of resistance to methicillin and tetracycline related to contrasting historical patterns of antibiotic usage between the livestock industry and human medicine. We also identified significant differences in patterns of gain and loss of different tetracycline resistance determinants, which we ascribe to epistatic interactions between the resistance genes and/or differences in the modes of inheritance of the resistance determinants.

Asunto(s)

Farmacorresistencia Bacteriana , Infecciones Estafilocócicas/transmisión , Infecciones Estafilocócicas/veterinaria , Staphylococcus aureus/efectos de los fármacos , Zoonosis/microbiología , Zoonosis/transmisión , Animales , Antibacterianos/farmacología , Utilización de Medicamentos , Variación Genética , Genotipo , Humanos , Ganado , Epidemiología Molecular , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/clasificación , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificación , Factores de Tiempo , Reino Unido/epidemiología

RESUMEN

Successful meticillin-resistant Staphylococcus aureus (MRSA) clones have evolved to adapt to healthcare, community and livestock environments. This review will bring together recent studies into clone adaptation and the importance of genes acquired during horizontal gene transfer to survival in specific environments. It will also discuss the role of global regulators controlling virulence gene expression and resistance to antibiotics, such as the agr and vraRS systems. Understanding these processes in successful clones could reveal novel targets for therapeutic agents, which are urgently required to reduce the infection burden and improve treatment options.

RESUMEN

Four cases of legionellosis caused by Legionella longbeachae serogroup (sg) 1 were identified in Scotland from 2008 to 2010. All case patients had exposure to commercially manufactured growing media or potting soils, commonly known as multipurpose compost (MPC), in greenhouse conditions, prior to disease onset. Two patients had been using the same brand of MPC but the clinical isolates were distinct genotypically by amplified fragment length polymorphism (AFLP) analysis. However, an indistinguishable AFLP profile was also found in an environmental isolate from the supply of MPC used by each patient. The third patient was diagnosed by immunofluorescent antibody serology only; however, the MPC to which this patient was exposed contained L. longbeachae sg 1 in large quantities (80 000 c.f.u. g(-1)). The fourth patient was L. longbeachae sg 1 culture-positive, but L. longbeachae was not identified from 10 samples of garden composting material. As compost is commonly used, but L. longbeachae infection seemingly rare, further work is required to ascertain (i) the prevalence and predictors of L. longbeachae in compost and (ii) the conditions which facilitate transmission and generate an aerosol of the bacteria. As most cases of legionellosis are diagnosed by urinary antigen that is Legionella pneumophila-specific and does not detect infection with L. longbeachae, patients in cases of community-acquired pneumonia with a history of compost exposure should have serum and respiratory samples sent to a specialist Legionella reference laboratory for analysis.

Asunto(s)

Exposición a Riesgos Ambientales , Legionella longbeachae/aislamiento & purificación , Legionelosis/epidemiología , Legionelosis/microbiología , Microbiología del Suelo , Suelo , Anciano , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Análisis por Conglomerados , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Femenino , Genotipo , Humanos , Legionella longbeachae/clasificación , Masculino , Persona de Mediana Edad , Tipificación Molecular , Escocia/epidemiología , Serotipificación

RESUMEN

OBJECTIVE: To estimate the proportion of patients who acquire methicillin-resistant Staphylococcus aureus (MRSA) while in hospital and to identify risk factors associated with acquisition of MRSA. DESIGN: Retrospective cohort study. PATIENTS: Adult patients discharged from 36 general specialty wards of 2 Scottish hospitals that had implemented universal screening for MRSA on admission. METHODS: Patients were screened for MRSA on discharge from hospital by using multisite body swabs that were tested by culture. Discharge screening results were linked to admission screening results. Genotyping was undertaken to identify newly acquired MRSA in MRSA-positive patients on admission. RESULTS: Of the 5,155 patients screened for MRSA on discharge, 2.9% (95% confidence interval [CI], 2.43-3.34) were found to be positive. In the subcohort screened on both admission and discharge (n = 2,724), 1.3% of all patients acquired MRSA while in hospital (incidence rate, 2.1/1,000 hospital bed-days in this cohort [95% CI, 1.5-2.9]), while 1.3% remained MRSA positive throughout hospital stay. Three risk factors for acquisition of MRSA were identified: age above 64 years, self-reported renal failure, and self-reported presence of open wounds. On a population level, the prevalence of MRSA colonization did not differ between admission and discharge. CONCLUSIONS: Cross-transmission of MRSA takes place in Scottish hospitals that have implemented universal screening for MRSA. This study reinforces the importance of infection prevention and control measures to prevent MRSA cross-transmission in hospitals; universal screening for MRSA on admission will in itself not be sufficient to reduce the number of MRSA colonizations and subsequent MRSA infections.

Asunto(s)

Infección Hospitalaria/epidemiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/transmisión , Factores de Edad , Anciano , Anciano de 80 o más Años , Infección Hospitalaria/diagnóstico , Femenino , Hospitales/estadística & datos numéricos , Humanos , Masculino , Tamizaje Masivo , Staphylococcus aureus Resistente a Meticilina/genética , Persona de Mediana Edad , Admisión del Paciente/estadística & datos numéricos , Alta del Paciente/estadística & datos numéricos , Insuficiencia Renal/complicaciones , Estudios Retrospectivos , Escocia/epidemiología , Autoinforme , Infecciones Estafilocócicas/diagnóstico , Heridas y Lesiones/complicaciones

RESUMEN

Legionella pneumophila and Legionella species were isolated from composted material when freshly prepared buffered charcoal yeast extract (BCYE) was supplemented with glycine (1.5 g/L), polymyxin B sulfate (40 000 IU/L), vancomycin hydrochloride (0.5 mg/L) and cycloheximide (40 mg/L) (GVPC medium) and Modified Wadowsky-Yee (MWY) (Oxoid, Cambridge, UK) plates were used for cultivation, but not with commercially sourced pre-poured GVPC and MWY plates (Oxoid). Legionella cincinnatiensis and pathogenic L. pneumophila serogroup (Sg) 1 Benidorm and France/Allentown were identified, as well as a non-typeable (NT) strain of L. pneumophila. As most laboratories no longer produce their own media, this may contribute to the lack of positive cultures from composted material. The antigenicity of the NT strain is discussed.

Asunto(s)

Medios de Cultivo/química , Legionella/aislamiento & purificación , Microbiología del Suelo , Suelo/química , Antígenos Bacterianos/inmunología , Técnicas Bacteriológicas , Cicloheximida/química , Glicina/química , Técnicas para Inmunoenzimas , Separación Inmunomagnética , Legionella/clasificación , Legionella/crecimiento & desarrollo , Legionella/inmunología , Polimixina B/química , Suelo/análisis , Vancomicina/química

RESUMEN

Epidemic meticillin-resistant Staphylococcus aureus-16, which was widespread throughout the UK and the rest of the world, has declined markedly in recent years. The reasons for this are not clear.

Asunto(s)

Bacteriemia/epidemiología , Epidemias , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/epidemiología , Bacteriemia/microbiología , Humanos , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/genética , Prevalencia , Infecciones Estafilocócicas/microbiología , Reino Unido/epidemiología

RESUMEN

Injecting drug users are prone to atypical infections. We present a case of septic thrombophlebitis secondary to Fusobacterium gonidiaformans infection in a heroin user, which demonstrates the frequently unusual nature of pathogens and presentations in this group of patients.

Asunto(s)

Infecciones por Fusobacterium/complicaciones , Infecciones por Fusobacterium/diagnóstico , Dependencia de Heroína/microbiología , Sepsis/microbiología , Tromboflebitis/microbiología , Adulto , Antibacterianos/uso terapéutico , Fusobacterium/aislamiento & purificación , Infecciones por Fusobacterium/tratamiento farmacológico , Dependencia de Heroína/complicaciones , Humanos , Masculino , Sepsis/complicaciones , Sepsis/diagnóstico , Abuso de Sustancias por Vía Intravenosa/complicaciones , Tromboflebitis/complicaciones

RESUMEN

This study explored strain distribution and resistance patterns of methicillin-resistant Staphylococcus aureus (MRSA) over a 5-year period in northeastern Scotland. We noted a shift in the relative rates of epidemic strains and an increase in community-associated strains. Use of oral antibiotics to eradicate throat carriage may have contributed to trimethoprim resistance, which was observed to increase 10-fold.

Asunto(s)

Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Staphylococcus aureus Resistente a Meticilina/clasificación , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Antibacterianos/administración & dosificación , Portador Sano/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Escocia/epidemiología , Staphylococcus aureus , Trimetoprim/administración & dosificación , Trimetoprim/farmacología

RESUMEN

In the United Kingdom, EMRSA-15 and EMRSA-16 account for the majority (∼90%) of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections. Currently, the standard typing technique, pulsed-field gel electrophoresis (PFGE), is laborious and insufficient for discriminating between closely related subtypes of EMRSA-15 and -16. The objective of the present study was to compare the usefulness of multilocus variable-number tandem-repeat fingerprinting (MLVF) and multilocus variable-number tandem-repeat analysis (MLVA) with PFGE for subtyping these highly clonal MRSA lineages. A panel of 85 MRSA isolates (41 EMRSA-15, 20 EMRSA-16, and 24 MRSA isolates with diverse PFGE patterns) was investigated. In addition, a further 29 EMRSA-15s with identical PFGE patterns from two geographically linked but epidemiologically distinct outbreaks and several sporadic cases were analyzed. PFGE, MLVF, and MLVA resolved 66 (Simpson's index of diversity [SID] = 0.984), 51 (SID = 0.95), and 42 (SID = 0.881) types, respectively, among the 85 MRSA isolates. MLVF was more discriminatory than MLVA for EMRSA-15 and -16 strains, but both methods had comparable discriminatory powers for distinguishing isolates in the group containing diverse PFGE types. MLVF was comparable to PFGE for resolving the EMRSA-15s but had a lower discriminatory power for the EMRSA-16s. MLVF and MLVA resolved the 29 isolates with identical PFGE patterns into seven and six subtypes, respectively. Importantly, both assays indicated that the two geographically related outbreaks were caused by distinct subtypes of EMRSA-15. Taken together, the data suggest that both methods are suitable for identifying and tracking specific subtypes of otherwise-indistinguishable MRSA. However, due to its greater discriminatory power, MLVF would be the most suitable alternative to PFGE for hospital outbreak investigations.

Asunto(s)

Técnicas de Tipificación Bacteriana/métodos , Dermatoglifia del ADN/métodos , Electroforesis en Gel de Campo Pulsado , Staphylococcus aureus Resistente a Meticilina/clasificación , Repeticiones de Minisatélite , Infecciones Estafilocócicas/microbiología , Infección Hospitalaria/microbiología , Geografía , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Epidemiología Molecular/métodos , Reino Unido

RESUMEN

In September 2006, the seven-valent pneumococcal conjugate vaccine (PCV7; Prevenar) was introduced into the childhood vaccination schedule in the United Kingdom. We monitored the population of invasive pneumococci in Scotland in the 5 years preceding the introduction of PCV7 by using serogrouping, multilocus sequence typing (MLST), and eBURST analysis. Here, we present a unique analysis of a complete national data set of invasive pneumococci over this time. We observed an increase in invasive pneumococcal disease (IPD) caused by serotypes 1, 4, and 6 and a decrease in serogroup 14-, 19-, and 23-associated disease. Analysis of sequence type (ST) data shows a significant increase in ST306, associated with serotype 1, and a decrease in ST124, associated with serotype 14. There have also been increases in the amounts of IPD caused by ST227 (serotype 1) and ST53 (serotype 8), although these increases were not found to reach significance (P = 0.08 and 0.06, respectively). In the course of the study period preceding the introduction of PCV7, we observed considerable and significant changes in serogroup and clonal distribution over time.

Asunto(s)

Técnicas de Tipificación Bacteriana , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Polimorfismo Genético , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Dermatoglifia del ADN/métodos , ADN Bacteriano/genética , Femenino , Genotipo , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Epidemiología Molecular , Fenotipo , Vacunas Neumococicas/inmunología , Prevalencia , Escocia/epidemiología , Serotipificación , Streptococcus pneumoniae/aislamiento & purificación , Vacunas Conjugadas/inmunología , Adulto Joven

RESUMEN

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) with the type IV staphylococcal chromosomal cassette mec (SCCmec) is rarely reported as being acquired in hospital. We report a hospital outbreak, in Grampian, Scotland, of eight cases of skin and soft-tissue infections due to such a strain. All patients had been in the labour, delivery and maternity units of a small community hospital during a 7-month period. Typing by pulsed-field gel electrophoresis showed the isolates to be a single strain closely related to the USA800 lineage (paediatric clone) and additional typing confirmed it as ST5-MRSA-IV. Genes for exfoliative toxin A (ETA) and enterotoxin D were detected by PCR in all the isolates although none carried the Panton-Valentine leukocidin gene. Region-wide surveillance of over 6000 MRSA isolates collected from 1998 to 2004 showed that 95 (1.6%) were closely related to the outbreak strain although only 60 carried the ETA gene. The strain has not been seen elsewhere in Scotland.

Asunto(s)

Infección Hospitalaria/epidemiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Cutáneas Estafilocócicas/epidemiología , Adulto , Proteínas Bacterianas/genética , Infecciones Comunitarias Adquiridas/epidemiología , Brotes de Enfermedades , Electroforesis en Gel de Campo Pulsado , Exfoliatinas/genética , Femenino , Humanos , Recién Nacido , Staphylococcus aureus Resistente a Meticilina/genética , Proteínas de Unión a las Penicilinas , Escocia/epidemiología

RESUMEN

The incidence of the epidemic methicillin-resistant Staphylococcus aureus (EMRSA) strains EMRSA-15 and EMRSA-16 in Scotland has increased dramatically, now accounting for c. 70% and c. 20% of isolates, respectively. Epidemiological tracking of these EMRSA strains is difficult, as c. 50% of EMRSA-15 and c. 35% of EMRSA-16 isolates are indistinguishable using pulsed-field gel electrophoresis (PFGE) and other typing methods. The usefulness of mec-associated direct repeat unit (dru) sequence analysis as a more sensitive approach to tracking the persistence and spread of these 'clonal' EMRSA strains in Scotland was evaluated. Analysis of 47 EMRSA-15 and 57 EMRSA-16 isolates (including two separately cultured isolates of the Harmony collection type strain) obtained from 22 hospital laboratories over an 8-year period (1997-2005) revealed 13 and 12 different dru types, respectively. Whereas some types appeared to be endemic in multiple hospitals, subtypes that may represent specific strain movement among hospitals in a given geographical region were identified in other instances. These results suggest that mec-associated dru typing may have potential for identifying and tracking specific subtypes of otherwise indistinguishable epidemic MRSA isolates such as those in Scotland.

Asunto(s)

Técnicas de Tipificación Bacteriana , ADN Bacteriano/genética , Resistencia a la Meticilina , Secuencias Repetitivas de Ácidos Nucleicos , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/clasificación , Staphylococcus aureus/genética , Secuencia de Bases , Genotipo , Humanos , Epidemiología Molecular , Datos de Secuencia Molecular , Escocia/epidemiología , Alineación de Secuencia , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación

RESUMEN

Two elderly residents of a care home were hospitalised with pneumonia over a period of one month. They had bacteraemia with penicillin non-susceptible Streptococcus pneumoniae (PNSP) and both died. All residents and staff of the care home were screened for PNSP using nasopharyngeal swabs, with one resident and one member of staff found to be asymptomatic carriers. Oral rifampicin was given to the carriers. All four strains were found to be serotype 14, and multilocus sequence typing (MLST) showed ST2652, not previously detected in Scotland. Review of care home residents showed that pneumococcal vaccination coverage was low (63%). This is similar to rates found in those aged > or =65 years in the general population and needs to be improved upon.

Asunto(s)

Infección Hospitalaria/epidemiología , Resistencia a las Penicilinas , Neumonía Neumocócica/epidemiología , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/aislamiento & purificación , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Técnicas de Tipificación Bacteriana , Portador Sano/tratamiento farmacológico , Portador Sano/microbiología , Infección Hospitalaria/microbiología , Femenino , Genotipo , Humanos , Masculino , Nasofaringe/microbiología , Casas de Salud , Neumonía Neumocócica/microbiología , Rifampin/uso terapéutico , Escocia/epidemiología , Serotipificación , Streptococcus pneumoniae/clasificación

RESUMEN

Sequence types of pneumococci isolated in Scotland between 1996 and 2003 were compared with those of globally prevalent antibiotic-resistant clones. Multilocus sequence typing was performed on 252 invasive pneumococcal isolates referred to the Scottish Meningococcus and Pneumococcus Reference Laboratory. Isolates were not preselected for antimicrobial resistance, patient age or disease caused. Sequence types were compared with globally significant antimicrobial-resistant clones identified by the Pneumococcal Molecular Epidemiology Network (PMEN). Sequence types identical with three of the 26 PMEN clones were present in the Scottish collection; the clones were the Spain(9V)-3 clone (sequence type 156, seven isolates), the England(14)-9 clone (sequence type 9, eight isolates) and the Utah(35B)-24 clone (sequence type 377, one isolate). Many Scottish isolates related to PMEN clones had lower antimicrobial MICs than those described for the corresponding PMEN type strain. A number of single- (SLVs) and double-locus variants (DLVs) were present. Fifteen SLVs related to PMEN sequence types 37, 67, 90, 81, 156, 236 and 377 were detected. The collection contained 10 DLVs related to PMEN sequence types 37, 156, 173 and 338. The majority of SLVs and DLVs were penicillin- or erythromycin-sensitive variants of the resistant PMEN type strains. Capsule switching in isolates related to the PMEN clones was also detected. The highest levels of penicillin resistance were detected in sequence type 320 (serotype 19F), which is not a PMEN clone. These data suggest that PMEN clones are not widely distributed in disease-causing isolates in Scotland.

Asunto(s)

Técnicas de Tipificación Bacteriana/métodos , Farmacorresistencia Bacteriana , Infecciones Neumocócicas/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Antibacterianos/farmacología , Hospitales , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones Neumocócicas/microbiología , Escocia/epidemiología , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/genética

Asunto(s)

Antibacterianos/farmacología , Eritromicina/farmacología , Streptococcus pneumoniae/efectos de los fármacos , Farmacorresistencia Bacteriana , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Filogenia , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Escocia/epidemiología , Serotipificación/métodos , Streptococcus pneumoniae/genética

Asunto(s)

Infecciones por Salmonella/microbiología , Salmonella enterica/enzimología , Salmonella enterica/genética , beta-Lactamasas/genética , Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Pruebas de Sensibilidad Microbiana , Escocia

Asunto(s)

Técnicas de Tipificación Bacteriana/métodos , Brotes de Enfermedades , Meningitis Meningocócica/microbiología , Neisseria meningitidis/clasificación , Adolescente , Adulto , Femenino , Genes Bacterianos , Humanos , Lactante , Masculino , Meningitis Meningocócica/epidemiología , Porinas/genética , Escocia/epidemiología

RESUMEN

AIMS: To describe the laboratory confirmation of meningococcal disease, using culture and non-culture based techniques, between 1993 and 1999 as part of a national service in Scotland. METHODS: Samples from patients with suspected meningococcal disease in Scotland were analysed by culture and non-culture based techniques to gain a laboratory confirmation of disease. Data were analysed to establish the number of disease cases, the serogroups of the organisms involved, and the importance of the techniques used. RESULTS: Between 1993 and 1999, there was a total of 1749 notified cases of meningococcal disease in Scotland. Culture based methods provided a laboratory confirmation of 788 cases whereas non-culture techniques confirmed 461 cases. CONCLUSIONS: Non-culture techniques were a useful addition to culture based techniques in Scotland and improved the dataset required for public health management, disease surveillance, and vaccine policy.

Asunto(s)

Infecciones Meningocócicas/diagnóstico , Pruebas de Aglutinación/métodos , Anticuerpos Antibacterianos/sangre , Técnicas de Tipificación Bacteriana/métodos , Técnicas Bacteriológicas/métodos , Humanos , Incidencia , Infecciones Meningocócicas/epidemiología , Neisseria meningitidis/clasificación , Neisseria meningitidis/inmunología , Neisseria meningitidis/aislamiento & purificación , Faringe/microbiología , Reacción en Cadena de la Polimerasa , Escocia

RESUMEN

A fluorescence-based PCR method was developed, fully automated, and used to confirm infection with Neisseria meningitidis by detection of the meningococcus-specific ctrA gene. The method provided a highly sensitive, high-throughput assay that was reproducible and less labor-intensive than manual methods.

Asunto(s)

Proteínas de Unión al ADN , Infecciones Meningocócicas/diagnóstico , Neisseria meningitidis/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Robótica , Factores de Transcripción , Proteínas Bacterianas/genética , Fluorescencia , Humanos , Infecciones Meningocócicas/microbiología , Neisseria meningitidis/genética , Reacción en Cadena de la Polimerasa/instrumentación

RESUMEN

The meningococcus is an important cause of morbidity and mortality and a rapid laboratory diagnosis is required through accurate, non-culture-based methods. Body fluids that are easily obtainable are preferred for this route of diagnosis and urine is the specimen of choice as it can be obtained non-invasively. Urine samples were tested from patients with suspected meningococcal disease and tested by latex agglutination and PCR. It was shown that urinary PCR is not useful for the laboratory confirmation of MD but latex agglutination testing may be useful in certain settings prior to confirmatory testing by a reference laboratory.

Asunto(s)

Antígenos Bacterianos/orina , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/orina , Neisseria meningitidis/aislamiento & purificación , Bacteriuria/diagnóstico , Técnicas de Laboratorio Clínico , ADN Bacteriano , Humanos , Pruebas de Fijación de Látex/métodos , Neisseria meningitidis/inmunología , Reacción en Cadena de la Polimerasa/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad