Diagnosis of Acute Bacterial Meningitis by PCR and the Problem of Isolating the Causative Bacterial Agents by Culture in Burkina Faso

In Burkina Faso, meningitis is epidemic, pneumococcus, meningococcus and Haemophilus influenzae are the most implicated. The aim of this study was to assess the prevalence of ABM characterized by PCR and culture in order to highlight the low yield of the culture. This is a prospective study on 26 health districts of surveillance between 2016 and 2019. The CSF sent were cultured, treated by direct PCR, i.e. from CSF without DNA extraction at the National Meningitis Reference Laboratory of Burkina Faso and at the CDC Atlanta. Several series of direct PCR were carried out for species diagnosis (lytA, sodC and hpd), serotyping of meningococcus and serotyping of pneumococcus (capsular genes) and Haemophilus influenzae (capsular genes). Two thousand eight hundred and forty-five (2,845) CSF were treated with 701 positives and a positivity rate of 24.75%. Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae represent respectively 39.2%, 51.9% and 8.9%. The strains of Neisseria meningitidis and Streptococcus pneumoniae were sensitive to antibiotics except 3 strains of Neisseria meningitidis, resistant to oxacillin. There is a drop in the positivity rate compared to previous years. Pneumococcus remains in the lead with serotype 1 (more than 50%) despite the introduction of PCV13.