Detection of haemophilus influenzae type B in cerebrospinal fluid of suspected children with meningitis by PCR

Background: A polymerase chain reaction (PCR) assay with primers from “hpd” gene was compared with culture for the detection of Haemophilus influenzae type b (Hib) in CSF samples from children suspected of meningitis. Methods: 300 cerebrospinal fluid (CSF) samples from suspected meningitis cases were studied by culture (Leventhal & Chocolate Agar) and PCR. Results: The latter method could detect Hib in all 5 culture positive and in 2 of 295 culture negative cases, showing sensitivity, specificity, and an accuracy index of 100%, 99% and 99%, respectively. The PCR result was available within a day. Conclusion: This study has shown that PCR is a rapid, sensitive, and specific diagnostic test for Hib from CSF samples. Furthermore, to maximize management of meningitis cases to reduce the morbidity, mortality, and complications of invasive Hib infection a combination of culture and PCR is necessary for the detection of Hib infection. The incidence of Hib meningitis among children in Children’s Medical Center in Tehran based on culture and PCR results were 2.4 % and 1.7% respectively. Based on culture results, Hib causes 15.6% of all cases of bacterial meningitis in children.

Haemophilus influenzae type b; Meningitis; PCR; culture; CSF; Iran; Incidence