Neisseria meningitidis – Real-time PCR

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Testing Indications

This test is offered under the following conditions:

When the clinical picture is consistent with a diagnosis of invasive meningococcal disease.
When the submitting laboratory is unable to culture N. meningitidis after 24-48 hours incubation and meningococcal disease is still suspected (e.g. due to use of antibiotics prior to obtaining a specimen from the patient)

Contact PHO Laboratory Customer Service Centre prior to collection of specimens

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Neisseria meningitidis PCR	General Test Requisition	CSF	250 μl	Sterile container
Neisseria meningitidis PCR	General Test Requisition	Whole blood or plasma in EDTA	250 μl	ETDA

Submission and Collection Notes

Include gram stain results and clinical information on the General Test Requisition Form.

Limitations

Haemolysed, icteric, lipemic or microbially contaminated sera or plasma are not recommended for testing.

Storage and Transport

Label the specimen container with the patient’s full name, date of collection and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.

Special Instructions

Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection and shipped to PHOL on ice packs.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

The Neisseria meningitidis – Real-time PCR test is performed as needed Monday to Friday.

Turnaround time is up to 3 days from receipt by PHO laboratory.

STAT and Critical Samples Testing

Testing on weekends may be performed under special circumstances. Contact the After-hours emergency duty officer at 416-605-3113 for after-hours consultation.

Test Methods

Neisseria meningitidis specimen nucleic acids are tested using a Real-Time polymerase chain reaction (PCR) detection of a Neisseria meningitidis carbohydrate transporter (ctrA) and capsular biosynthesis genes for serogroups A, B, C, W135, X and Y.

The sensitivity of the Real Time PCR test is higher than conventional culture.

Reporting

Results are reported to the ordering physician or health care provider as indicated on the requisition.

Specimens that are positive for Neisseria meningitidis are to be reported to the Medical Officer of Health as per Health Protection and Promotion Act.