The National Meningitis Reference Laboratory was formed in 1989 and has functioned in the National School of Public Health since 1993, providing reference as well as diagnostic services for hospitals all over Greece.
Its activities include investigation of the micro-organisms causing meningitis (bacterial and viral), such as Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, Streptococcus spp., Pseudomonas aeruginosa, Haemophilus spp. (non-b) and Staphylococcus aureus, mainly by molecular but also by conventional techniques.
The reference laboratory has developed and implemented the following multiplex polymerase chain reaction (mPCR) assays for identification, as well as further typing.
A. Identification techniques
- mPCR assays for the simultaneous detection of N. meningitidis, S. pneumoniae, H. influenzae type b and L. monocytogenes.
- mPCR assay for the simultaneous detection of meningococcal serogroups (A, B, C, W-135 and Y).
- mPCR assays for the simultaneous detection of Streptococcus spp. (group A and group B), P. aeruginosa, Haemophilus spp. (non-b) and S. aureus.
- mPCR for simultaneous detection of nine major serotypes of S. pneumoniae (1, 3, 4, 6, 14, 18, 19A, 19F and 23F). Six of these serotypes are included in the 7-valent conjugate vaccine.
- Real-time PCR for the detection of N. meningitides.
B. Further typing techniques
- Multilocus sequence typing (MLST) for molecular typing of N. meningitidis (strains and biological materials).
- Development and application of variable tandem repeats (VNTR) for typing N. meningitidis either in isolates or directly in biological fluids.
- Random amplification of polymorphic DNA (RAPD).
- PorA and FetA N. meningitidis typing
In addition, the reference laboratory carries out laboratory epidemiology of strains from other Balkan countries (Albania, Bulgaria and Romania), helps in the early detection and identification of new serotypes in Greece, collects epidemiological data on new vaccines and evaluates their effect on the Greek population and participates in evaluation of new vaccines, either by providing molecular data for the characteristics of the Greek strains, or carrying out novel techniques on the effects of the vaccines under investigation for Greece (e.g. the meningococcal antigen typing system, MATS technique).
• Recording trends in the antibiotic resistance of N. meningitidis strains.
• Informing the public of meningitis by issuing leaflets about the symptoms, treatment and prevention of the disease.
The reference laboratory is the only specialized laboratory for meningitis in Greece and, because it can apply molecular diagnoses, samples are sent from hospitals from all over the country. In this way, 80–90% of meningitis cases as well as pneumonia are diagnosed, mainly from biological materials.
Professor Jenny Kremastinou Professor of Public Health and President of HCDCP