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Review
. 2025 Apr 22:13:1511086.
doi: 10.3389/fped.2025.1511086. eCollection 2025.

Current methods in the diagnosis of invasive meningococcal disease

Ergin Ciftci  1 , Duygu Ocal  2 , Ayper Somer  3 , Hasan Tezer  4 , Dilek Yilmaz  5 , Sirac Bozkurt  6 , Oldac Uras Dursun  6 , Şeyhmus Merter  6 , Ener Cagri Dinleyici  7
Affiliations
Review

Current methods in the diagnosis of invasive meningococcal disease

Ergin Ciftci et al. Front Pediatr. .

Abstract

Invasive meningococcal disease (IMD) remains a significant health concern due to its global distribution, potential for epidemic spread, unpredictable nature, rapid progression, and high mortality rates or permanent sequelae. The global elimination of meningococcal illness via immunization is a primary objective of the World Health Organization's strategy to defeat meningitis by 2030. Timely recognition of meningococcal infection and immediate, precise, and specific identification of Neisseria meningitidis are essential for optimal clinical management and enhanced outcomes, monitoring evolving meningococcal epidemiology, detecting outbreak activity, and providing an effective public health response. Clinical findings, microscopic findings, Gram stains, and cultures are traditional and widely used diagnostic methods for the definition of IMD, despite some disadvantages. Real-time polymerase chain reaction (rt-PCR) and whole genome sequencing (WGS) are more accurate techniques for the identification of N. meningitidis and subsequent investigation; however, their cost and limited availability present issues. WGS has numerous uses, including strain characterization, population genomics, antibiotic resistance monitoring, and outbreak investigation. New-generation molecular technologies have been and will be used for designing meningococcal vaccines, as well as to monitor dynamic molecular meningococcal seroepidemiology. Microbiology reference laboratories are important, and the digital records and expertise they provide benefit public health for N. meningitidis, as well as other pathogens. While there has been significant progress in the development of meningococcal infection diagnostic tools, it is probable that a combination of approaches or new strategies will still be necessary. The goal of this review was to evaluate the current methods for diagnosing IMD and to discuss diagnostic challenges in practice.

Keywords: Neisseria meningitidis; PCR; culture; diagnostic; invasive meningococcal disease; laboratory tests; whole genome sequencing.

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Conflict of interest statement

EC has acted in advisory board of GSK, MSD, Pfizer, and Sanofi Pasteur and has received speaker honorarium from GSK, MSD, Pfizer, and Sanofi Pasteur. HTperforms contract work (advisory board member, speaker) for Gazi University funded by GSK, Pfizer, MSD and Sanofi Pasteur. SB, OD and SM are employees of Pfizer. ED performs contract work (advisory board member, speaker and grant) for Eskisehir Osmangazi University funded by GSK, Pfizer, and Sanofi Pasteur. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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