Isolation of Neisseria meningitidis from sputum/bronchial secretions from immunocompromised patients

Abstract number: 1135_117

Tzanakaki G., Kanellopoulou M., Skarmoutsou N., Martsoukou M., Kesanopoulos K., Charalampopoulou A., Adamou D., Floropoulou G., Kremastinou J., Papafrangas E.

Objectives:  

Two cases of immunocompromised patients in which Neisseria meningitidis strains were isolated from sputum/bronchial secretions are presented in this study.

Methods:  

Both sputum and bronchial secretions were cultured in blood/chocolate agar. Isolation and identification of N. meningitidis strains, were performed according to conventional microbiological procedures. To the isolated N. meningitidis strains, serogroup was performed by the slide agglutination test and serosubtyping by the use of monoclonal antibodies with Whole-cell ELISA. Simultaneous diagnostic approach was carried out by the use of PCR in whole blood samples of the two patients. The amplified gene was crgA specific for N. meningitidis and siaD specific for serogroups A, B, C and Y. The amplification products were 230 bp for N. meningitidis and 450 bp, 250 bp, 400 bp, and 120 bp for the serogroups B, C, A, and Y, respectively.

Results:  

In the first case although the blood cultures were negative, PCR in the whole blood was positive for N. meningitidis serogroup W-135, indicating meningococcal septicemia and the same strain was isolated from the sputum. In the second case, N. meningitidis serogroup C:4:P1.14 strain was isolated from the bronchial secretions although blood cultures and PCR was negative.

Conclusions:  

N. meningitidis in sputum or bronchial may cause severe bacteraemia or meningococcal disease especially in immunocompromised patients. PCR detecting genetic material of N. meningitidis in whole blood, play important role in laboratory diagnosis of the infection. In cases in which N. meningitidis is isolated from respiratory tract infections, this should be notified and chemoprophylaxis must be given to avoid complications of meningitis or septicaemia.