Sampling methods to detect carriage of Neisseria meningitidis; literature review

Roberts, J; Greenwood, B; Stuart, J; (2009) Sampling methods to detect carriage of Neisseria meningitidis; literature review. The Journal of infection, 58 (2). pp. 103-107. ISSN 0163-4453 DOI:

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Objectives: Studies of meningococcal carriage are important in understanding the epidemiology of meningococcal disease and the impact of vaccination programmes. However, microbiological sampling methods to determine pharyngeal carriage are not consistent between studies and the optimal method is uncertain. Methods: A comprehensive Literature search was undertaken using Medline, Embase and the Cochrane Library (Feb 2008) to identify studies comparing isolation rates using different sampling methods. Results: Four studies compared isolation of meningococci from different pharyngeal sites. Nasopharyngeal swabs taken through the nose were less likely to yield meningococcal cultures than pharyngeal swabs taken through the mouth. One study investigated different sampling sites using swabs taken through the mouth and found higher yields from the posterior pharyngeal watt compared to the tonsils (32.2% cf 19;4%, p = 0.001). Four studies compared the yield obtained using transport medium to direct plating. Loss of yield in transport medium ranged from 5.7% to 16.4% after storage for >5 h. Conclusions: The evidence to date suggests that meningococcal carriage should be assessed by swabbing the posterior pharyngeal wait through the mouth, and that swabs should be plated directly on site or placed in transport medium for <5 h. Summary: The current literature suggests meningococcal carriage is best assessed by swabbing the posterior pharyngeal wall through the mouth with direct plating or keeping transport time to below 5 h. Whether a swab taken from both the posterior pharynx and the tonsils improves yield further needs evaluation. (C) 2009 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Keywords: Carrier State, diagnosis, microbiology, Humans, Meningococcal Infections, diagnosis, microbiology, Neisseria meningitidis, isolation & purification, Pharynx, microbiology, Specimen Handling, methods
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Vaccine Centre
PubMed ID: 19167762
Web of Science ID: 264182200002


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