© 2002 Journal of Clinical Pathology
ECHO
Severity of meningococcal disease
The number of bacteria in the blood determines the severity of meningococcal disease, predictably perhaps, but only recently shown in a study involving Alder Hey Children's Hospital, Liverpool, and the PHLS Meningococcal Reference Unit (MRU) in Manchester, UK.Meningococcal disease can present as meningitis or septicaemia, or both; septicaemia carries a mortality of 6–75%. Its severity seems to hinge on patients' serum concentrations of certain cytokines, bacterial lipo-oligosaccharide (LOS) endotoxin, and bacterial capsular polysaccharide antigen. LOS and antigen concentrations may or may not be proportional to bacterial numbers.
The researchers used Taqman polymerase chain reaction (PCR) of a universal meningococcal capsular gene to measure bacterial numbers accurately in blood samples taken at admission and sequentially from children with probable/ possible meningococcal disease. With one gene per cell, the number of genome copies measured per ml of blood equals bacterial load (viable and dead bacteria). Higher bacterial load at admission occurred
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