Original scientific paper
Microbiological diagnostics of invasive meningococcal disease in Croatia – are standard methods optimal methods even today
Suzana Bukovski
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb i Medicinski fakultet Osijek, Sveušilište Josip Juraj Strossmayer u Osijeku, Osijek, Hrvatska
Marko Jelić
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Marija Gužvinec
; Klinika za infektivne bolesti "Dr. Fran Mihaljević", Zagreb, Hrvatska
Abstract
Culture-confirmed diagnosis of invasive meningococcal disease (IMD) is often hindered by early antibiotic treatment. Nonculture molecular standardized methods are now essential tools and almost "new gold standard" in microbiological diagnostics of IMD in developed world and recommended tool in other parts of the world. The introduction of the real time PCR in routine diagnostics of IMD at the University Hospital for Infectious Diseases (UHID) in 2005 significantly improved etiological diagnosis of disease. More than 50% of IMD cases of hospitalized patients in UHID from January 2005 to April 2013 were confirmed only by real time PCR. The emergence of penicillin resistant N. meningitidis invasive isolates leads us to the introduction of the detection of penA gene responsible for penicillin resistance. Nevertheless, IMD prophylaxis in Croatia may continue to be based on the current recommendations of epidemiological service due to proved susceptibility to all antibiotics commonly used for this purpose, rifampicin, ciprofloxacin and ceftriaxone. Serotyping and serosubtyping are not any more recommended in routine characterization of meningococcal isolates. OMV vaccines against N. meningitidis serogroup B, prepared from outer membrane proteins, have not proved to be successful supranational. However, after the development of reverse vaccinology and multicomponent MenB (fHBP, NHBA, NadA, OMP New Zealand – P1.7-2,4) vaccine genotyping was placed as an important tool for following up characteristics of invasive meningococcal isolates as well as following up of vaccine coverage with the available new and future MenB vaccines or perhaps broad range vaccines. This will undoubtedly be a part of our future work on the national level and/or in cooperation with other European national reference centres and the European Centre for Disease Prevention and Control (ECDC).
Keywords
Invasive meningococcal disease; molecular methods; vaccines
Hrčak ID:
133463
URI
Publication date:
30.6.2014.
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