Audit of the detection and notification of meningococcal disease at a North London university district hospital.

M Ruddy, Y Drabu, P Lee, B C Patel
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Abstract

The microbiology department at a North London hospital audited notifications of suspected meningococcal disease in response to a reported high rate, which it suspected was due to over-reporting out of hours to public health specialists. All cases notified over a 14-month period were assessed with regards to time of reporting and subsequent microbiological confirmation. Of 36 notifications, 18 were confirmed as bacterial, mostly meningococcal meningitis. Of the four types of sample readily obtainable on admission (blood culture, ethylene diamine tetra-acetic acid [EDTA] blood sample, throat swab and acute serum) all were obtained in only two cases. The reporting was considered appropriate, reflecting the relatively high incidence of meningococcal disease (MD) within the local population. Further cases might perhaps have been laboratory confirmed had all samples been sent on admission. A single form requesting all four samples in suspected meningococcal disease cases is recommended. Informing public health specialists out of hours could be rationalised.

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北伦敦大学区医院脑膜炎球菌病的检测和通报审计。
北伦敦一家医院的微生物科审计了疑似脑膜炎球菌病的通报,以应对报告的高发病率,它怀疑这是由于超时向公共卫生专家报告所致。对14个月内报告的所有病例进行了报告时间和随后的微生物学确认评估。在36宗呈报个案中,18宗确诊为细菌性脑膜炎,多数为脑膜炎球菌性脑膜炎。入院时可获得的四种样本(血培养、乙二胺四乙酸[EDTA]血样、咽拭子和急性血清)中只有两例全部获得。报告被认为是适当的,反映了当地人口中脑膜炎球菌病(MD)的发病率相对较高。如果在入院时送出所有样本,可能会有更多病例得到实验室确认。在疑似脑膜炎球菌病病例中,建议填写一份单一表格,要求提供所有四份样本。在非工作时间通知公共卫生专家可以合理化。
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What should we measure: infection or infection control? Accountability for health protection in England: how this has been affected by the establishment of the Health Protection Agency. Evaluation of peer review of infection control arrangements for healthcare-associated infection in four acute care trusts in the East of England. Surveillance of antenatal infections--HIV, hepatitis B, syphilis and rubella susceptibility in London. How complete and accurate is meningococcal disease notification?
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