Birmingham researchers find new way to detect meningitis causes

Researchers in Birmingham have found a new way to identify the bacteria and viruses behind meningitis and encephalitis, two serious infections of the brain and spinal cord, which could help doctors find the cause when standard tests draw a blank.

The team from Aston University and the University of Birmingham used a technique called metagenomic sequencing on samples of cerebrospinal fluid, the clear fluid around the brain and spinal cord, taken from patients at University Hospitals Birmingham.

Looking for everything at once

Most tests look for one germ at a time, so doctors have to guess which ones to test for. Metagenomic sequencing reads all the genetic material in a sample, which means it can detect many different bacteria and viruses at the same time. The team combined it with a new computer filtering method to remove background noise and compared the results with samples from people who did not have an infection.

In some settings, including intensive care, no cause is found in more than half of cases of central nervous system infection using conventional methods.

Dr Ghaniah Hassan-Smith, a clinical senior lecturer at Aston Medical School and honorary consultant neurologist at University Hospitals Birmingham, said: "Metagenomic sequencing gives us the exciting possibility of looking much more broadly, including for unusual or unexpected causes."

The research team

The team also included Dr Zaki Hassan-Smith of Aston Medical School and University Hospitals Birmingham, and Professor Nicholas Loman, Dr Joshua Quick and Dr Nicola Cumley from the University of Birmingham. The work is published in BMC Infectious Diseases.

Why it matters

Meningitis and encephalitis can kill or cause lasting disability within hours. Knowing the exact cause helps doctors choose the right treatment and stop medicines that are not needed.

Know the signs

Symptoms of meningitis can include fever, a severe headache, a stiff neck, dislike of bright lights, drowsiness and a rash that does not fade under a glass. Anyone who suspects meningitis should call 999 or go to A and E straight away.