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侵袭性脑膜炎球菌病的当前诊断方法。

Current methods in the diagnosis of invasive meningococcal disease.

作者信息

Ciftci Ergin, Ocal Duygu, Somer Ayper, Tezer Hasan, Yilmaz Dilek, Bozkurt Sirac, Dursun Oldac Uras, Merter Şeyhmus, Dinleyici Ener Cagri

机构信息

Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Türkiye.

Department of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, Türkiye.

出版信息

Front Pediatr. 2025 Apr 22;13:1511086. doi: 10.3389/fped.2025.1511086. eCollection 2025.

Abstract

Invasive meningococcal disease (IMD) remains a significant health concern due to its global distribution, potential for epidemic spread, unpredictable nature, rapid progression, and high mortality rates or permanent sequelae. The global elimination of meningococcal illness immunization is a primary objective of the World Health Organization's strategy to defeat meningitis by 2030. Timely recognition of meningococcal infection and immediate, precise, and specific identification of are essential for optimal clinical management and enhanced outcomes, monitoring evolving meningococcal epidemiology, detecting outbreak activity, and providing an effective public health response. Clinical findings, microscopic findings, Gram stains, and cultures are traditional and widely used diagnostic methods for the definition of IMD, despite some disadvantages. Real-time polymerase chain reaction (rt-PCR) and whole genome sequencing (WGS) are more accurate techniques for the identification of and subsequent investigation; however, their cost and limited availability present issues. WGS has numerous uses, including strain characterization, population genomics, antibiotic resistance monitoring, and outbreak investigation. New-generation molecular technologies have been and will be used for designing meningococcal vaccines, as well as to monitor dynamic molecular meningococcal seroepidemiology. Microbiology reference laboratories are important, and the digital records and expertise they provide benefit public health for , as well as other pathogens. While there has been significant progress in the development of meningococcal infection diagnostic tools, it is probable that a combination of approaches or new strategies will still be necessary. The goal of this review was to evaluate the current methods for diagnosing IMD and to discuss diagnostic challenges in practice.

摘要

侵袭性脑膜炎球菌病(IMD)因其全球分布、潜在的流行传播、不可预测性、快速进展以及高死亡率或永久性后遗症,仍然是一个重大的健康问题。全球消除脑膜炎球菌疾病的免疫接种是世界卫生组织到2030年战胜脑膜炎战略的主要目标。及时识别脑膜炎球菌感染并立即进行准确、精确和特异性的鉴定,对于优化临床管理、改善治疗结果、监测不断演变的脑膜炎球菌流行病学、检测疫情活动以及提供有效的公共卫生应对措施至关重要。尽管存在一些缺点,但临床发现、显微镜检查结果、革兰氏染色和培养是定义IMD的传统且广泛使用的诊断方法。实时聚合酶链反应(rt-PCR)和全基因组测序(WGS)是用于鉴定及后续调查的更准确技术;然而,它们的成本和可用性有限带来了问题。WGS有许多用途,包括菌株特征分析、群体基因组学、抗生素耐药性监测和疫情调查。新一代分子技术已经并将用于设计脑膜炎球菌疫苗,以及监测动态分子脑膜炎球菌血清流行病学。微生物学参考实验室很重要,它们提供的数字记录和专业知识有利于公共卫生应对脑膜炎球菌以及其他病原体。虽然脑膜炎球菌感染诊断工具的开发取得了重大进展,但可能仍需要多种方法或新策略的组合。本综述的目的是评估当前诊断IMD的方法,并讨论实践中的诊断挑战。

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