Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae
WHO/CDS/CSR/EDC/99/7/EN
Laboratory Methods for the Diagnosis of Meningitis Caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae
Introduction Acknowledgements I. Epidemiology of Meningitis Caused by Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae II. General Considerations
A. Record Keeping III. Collection and Transport of Clinical Specimens
A.Collection of Cerebrospinal Fluid (CSF)
A1. Lumbar Puncture
B. Collection of Blood
B1. Precautions
B2. Sensitivity of Blood Cultures
B3. Venipuncture
C. Transport of Clinical Specimens
C1. CSF
C2. Blood IV. Primary Culture, Subculture and Presumptive Identification
A. Inoculation of Primary Culture Media
A1. CSF
1.1. Gram Stain Procedure for CSR (Hucker Modification)
1.2. General Methods for Performing Latex Agglutination Tests
A2. Blood
B. Subculture
B1. Blood Culture Bottle
B2. T-1 Medium
C. Macroscopic Examination of Colonies V. Identification of N. meningitidis
A. Kovac's Oxidase Test
B. Identification of the N. meningitidis Serogroup
C. Carbohydrate Utilization by N. meningitidis - Cystine Trypticase Agar Method
D. Commercial Identification Kits VI. Identification of S. pneumoniae
A. Susceptibility to Optochin
B. Bile Solubility Test
C. Slide Agglutination Test VII. Identification of H. influenzae
A. Identification of the H. influenzae Serotype
B. Identification of X and V Factor Requirements
B1. X, V and XV Paper Disks or Strips
B2. Haemophilus ID "Quad" Plates VIII. Preservation and Transport of N. meningitidis, S. pneumoniae, and H. influenzae
A. Short-Term Storage
B. Long-Term Storage
B1. Preservation by Lyophilization
B2. Preservation by Freezing
C. Transportation of Cultures
C1. Transport in Silica Gel Packages IX. Suggested Further Reading X. Annexes
A. Basic Requirements, Supplies and Equipment
B. Media and Reagents
C. Preparation of Media and Reagents
D. Serotyping of S. pneumoniae
E. Biotyping of H. influenzae