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First published in Brainwaves magazine

Automated PCR and sequence-based typing of meningocci — a new reference for Scotland.

Dr S. C. Clarke, Scottish Meningococcus and Pneumococcus Reference Laboratory, Stobhill Hospital, Glasgow

Medical microbiology has been entering a new era during the past decade. Automated and non-automated equipment has become available for the improved laboratory diagnosis of infectious diseases. Technology for this has also become more widely available and affordable. The Scottish Meningococcus and Pneumococcus Reference Laboratory (SMPRL) provides a national service for the laboratory confirmation of disease due to the meningococcus and pneumococcus. These two bacteria are the leading causes of bacterial meningitis. Results of tests performed at the SMPRL are disseminated to the requesting local microbiology laboratory, the Public Health Consultants, and to the Scottish Centre of Infection and Environmental Health.

Currently at the SMPRL a number of tests are performed on meningococcus and pneumococcus so that effective treatments can be given to the patient and so that outbreaks of disease can be monitored and dealt with effectively by the Public Health departments. To do the latter, the SMPRL performs what is known as 'typing', this enables bacteria from different patients to be compared so as to identify linked cases. This is important as vaccination can be given to patient contacts against one type of meningococcus, namely the group C type. Long-term surveillance of disease in Scotland can also be performed in this way so that treatment can be monitored and vaccine policies made.

Recently, the Meningitis Association of Scotland provided a generous donation to enable the SMPRL to purchase a robotic liquid-handling system and a DNA sequencer. Both items were purchased from MWG-Biotech, a relatively new player in the UK market, whose parent company is situated in Germany. The SMPRL required these two items to that a new DNA sequencing method could be performed. This method is known as multi-locus sequence typing (MLST). Researchers at Oxford University recently devised the MLST method for the typing of bacterial isolates based on gene sequencing. As this is sequence-based the typing results are also reproducible between laboratories. This method is needed to better differentiate common group B and C meningocodus types that occur in Scotland. Therefore, when more than one case of meningococcal disease occur in a defined setting, such a school, more informed decisions can by made regarding vaccination and antibiotic prophylaxis of school pupils or university students.

The availability of the liquid handling robot and DNA sequencer at the SMPRL will enable high-throughput sequencer and therefore typing of meningococcal isolates. At this time of the introduction of the new group C meningococcal disease is even more important. DNA sequence data will enable the SMPRL to monitor the epidemiology of meningococcal isolated in Scotland in more detail during outbreaks and for long-term surveillance.

"Eileen is a lady who does not take 'No' for an answer. If she did we would not have made as much progress as we have done to discover how risk factors for meningitis make children more susceptible to disease. We would not have had opportunities to examine new approaches to a vaccine for meningitis. We would not have the funds for a PhD studentship. We would not have had the 'bridging loans' for molecular epidemiology at the reference laboratory at Stobhill Hospital or the life saving equipment from children with meningitis at Yorkhill Hospital. Her encouragement, determination and hard work are appreciated by all of the research and clinical teams who have been supported by the Meningitis Association of Scotland".

Dr Caroline Blackwell

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