Neisseria meningitidis- Identification Confirmation and Serogrouping

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This page provides testing information on the confirmation of identification and serogrouping of Neisseria meningitidis cultured from normally sterile body sites. The causative agent of meningococcal disease is Neisseria meningitidis. For information regarding other testing options, refer to the following PHO webpage – Neisseria meningitidis – Real-time PCR.

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Testing Indications

Neisseria meningitidis serogrouping is performed on isolates cultured from sterile sites only.

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Neisseria meningitidis – Confirmation of identification and serogrouping	Reference Bacteriology Requisition	Pure viable subculture of organism on fresh blood agar plate	N/A	Appropriate media that supports the growth of an organism.
Neisseria meningitidis – Confirmation of identification and serogrouping	Reference Bacteriology Requisition	Swab of the pure subculture in Amies transport medium for identification/ serogrouping	N/A	Appropriate media that supports the growth of an organism.

Submission and Collection Notes

Complete all fields of the requisition form, including:

Test(s) requests (includes confirmation and identification) and indications for testing
Patient setting/population/source
Specimen source
Culture information (presumptive identification, gram morphology)
Clinical/ epidemiology information

For clinical specimens, label the specimen container(s) with the patient’s first and last name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. For additional information see: Criteria for Acceptance of Patient Specimens. Failure to provide this information may result in rejection or testing delay.

If a swab is received the turnaround time will be delayed 24 hours.

Primary cultures are unacceptable as they should be processed in the originating lab. The submitter will be contacted by telephone. A report will be issued to indicate that the test has been rejected

Limitations

Mixed or non-viable cultures will not be tested. The submitter will be contacted by telephone. A written report will be issued to indicate that the test has been rejected.
Mis-labelled or un-labelled specimens will not be tested.
The submitting laboratory will be contacted regarding isolates or specimens from sterile sites (eg. CSF) that are submitted inappropriately (mis-labelled or un-labelled)

Storage and Transport

Place specimen in biohazard bag and seal. Specimens should be stored at room temperature following collection and shipped to PHO Laboratory within 48 hours of collection. All clinical specimens must be shipped in accordance to the Transportation of Dangerous Good Act.

Label the specimen with the patient’s full name, date of collection and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Neisseria meningitidis- Confirmation of Identification and Serogrouping is performed daily (Monday – Saturday) at PHO Laboratory-Toronto.

Turnaround time is up to 4 days for identification confirmation. Serogrouping report is available within 24 hours of receipt of the specimen in the laboratory.

Turnaround time for serotyping and subtyping is up to 28 days.

Test Methods

Neisseria meningitidis isolates are identified/confirmed using all of the following methods:

Gram stain morphologic examination,
MALDI-TOF MS, and
Biochemical testing

Serogrouping is performed using an antiserum agglutination assay.

The specimen is also forwarded to the Public Health Agency of Canada in Winnipeg for serotyping and subtyping.

Interpretation

The Laboratory Test Report will show:

Identification of the isolate: “ Isolate identified as Neisseria meningitidis”
N. meningitidis serogroup: A or B or C or W or X or Y

Results are reported to the ordering physician or health care provider as indicated on the requisition.

Reporting

Results are reported to the physician, authorized health care provider (General O. Reg 45/22, s.18) or submitter as indicated on the requisition.

Specimens that are positive for Neisseria meningitidis from sterile sites (representing Invasive Meningococcal Disease – IMD)) are to be reported to the Medical Officer of Health as per Health Protection and Promotion Act.