International Medical Journal, Vol. 25., Iss. 1, 2019, P. 86−88.
OPTIMIZATION OF EARLY DIAGNOSIS OF ACUTE BACTERIAL MENINGITES
Kharkiv Medical Academy of Postgraduate Education
National Univeisity of Pharmacy, Kharkiv
V. N. Karazin Kharkiv National University
In recent decades, molecular genetic research methods, in particular, the polymerase chain reaction, have been used to improve the quality of etiological diagnosis of neuroinfections by clinicians. To assess the effectiveness of identification of N. meningitidis and Str. Pneumoniae in the patients with purulent bacterial meningitis at the local and systemic levels using the method of polymerase chain reaction 103 patients were examined in dynamics. In accordance with the diagnosis, the patients were divided into three groups: patients with etiologically undifferentiated purulent meningitis, in those the pathogen was not detected during bacteriological examination of cerebrospinal fluid and serum; patients with meningococcal meningitis for those N. meningitidis was detected in cerebrospinal fluid using bacteriological examination and the method of polymerase chain reaction; patients with pneumococcal meningitis, confirmed by the bacteriological method and polymerase chain reaction. The results of the study showed that when determining the etiological interpretation in patients with purulent bacterial meningitis, DNA detection of N. meningitidis and Str. pneumoniae in cerebrospinal fluid using the polymerase chain reaction was more specific than in serum. The information capacity of the serum polymerase chain reaction was higher in patients with acute meningitis meningococcal etiology if compared with pneumococcal meningitis. To improve the efficiency of the diagnosis of purulent bacterial meningitis using molecular genetic methods, it is advisable to study both cerebrospinal fluid and blood serum. Research data on blood serum of the patients with meningococcal and pneumococcal meningitis confirmed the pathogenesis of purulent bacterial meningitis: the pathogen was found more often and longer in the blood during meningococcal meningitis and rarely and briefly in pneumococcal meningitis. Further study of the effectiveness of molecular−genetic technologies for diagnosis of purulent bacterial meningitis using various biological materials of the patients will allow identifying a larger spectrum of pathogens of this group of diseases, and, possibly, the polymerase chain reaction will be the "platinum standard" in their diagnosis.
Key words: purulent bacterial meningitis, cerebrospinal fluid, blood serum, polymerase chain reaction.