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Le Bars H, Madany N, Lamoureux C, Beauruelle C, Vallet S, Payan C, Pilorgé L. Evaluation of the Performance Characteristics of a New POC Multiplex PCR Assay for the Diagnosis of Viral and Bacterial Neuromeningeal Infections. Diagnostics (Basel) 2023; 13:diagnostics13061110. [PMID: 36980418 PMCID: PMC10047878 DOI: 10.3390/diagnostics13061110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Point-of-care syndromic PCR (POC SPCR) assays are useful tools for the rapid detection of the most common causative agents of community-acquired infections responsible for meningitis and encephalitis infections. We evaluated the performance characteristics of the new QIAstat-Dx® Meningitis/Encephalitis panel (QS) compared to the laboratory reference methods and the POC SPCR Biofire® FilmArray® Meningitis Encephalitis Panel (FA). Viral (Enterovirus, Parechovirus, HSV-1, HSV-2, HHV-6, VZV) and bacterial (E. coli K1, H. influenzae, L. monocytogenes, encapsulated N. meningitidis, M. pneumoniae, S. agalactiae, S. pneumoniae, S. pyogenes) pathogens were suspended at low concentrations and tested with the POC SPCR systems. The reproducibility, analytical specificity, carryover contamination, interferences and clinical samples were evaluated. All samples tested positive with both QS and FA except for those containing the lowest concentrations of Enterovirus-D68-B3, Echovirus-30 and S. agalactiae which were only detected by FA. In terms of analytical specificity, we observed 3 false positive results out of 48 QS tests versus 1 out of 37 FA tests. For the other studied criteria, both QS and FA performed as expected. Our results suggest that the performance characteristics of QS are close to those of FA. A prospective multicenter study would be useful to complete the performances evaluation of QS.
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Affiliation(s)
- Hervé Le Bars
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Neil Madany
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
| | - Claudie Lamoureux
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Clémence Beauruelle
- Unity of Bacteriology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Sophie Vallet
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Christopher Payan
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Univ Brest, Inserm, EFS, UMR 1078, GGB CEDEX, F-29200 Brest, France
| | - Léa Pilorgé
- Unity of Virology, Department of Bacteriology-Virology-Parasitology-Mycology-Hygiene, Pole of Biology-Pathology, University Hospital of Brest, F-29200 Brest, France
- Correspondence: ; Tel.: +33-298-347-191; Fax: +33-298-347-193
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Lin M, Li YR, Lan QW, Long LJ, Liu JQ, Chen YW, Cao XJ, Wu GY, Li YP, Guo XG. Evaluation of GeneXpert EV assay for the rapid diagnosis of enteroviral meningitis: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2022; 21:25. [PMID: 35681153 PMCID: PMC9185958 DOI: 10.1186/s12941-022-00517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 05/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background GeneXpert enterovirus Assay is a PCR-based assay for Enterovirus meningitis diagnosis. However, there is currently no research about the performance of GeneXpert enterovirus assay in the diagnosis of enterovirus meningitis. Thus, a systematic review and meta-analysis is significant on the topic. Methods Embase, Cochrane Library, Web of Science, and PubMed were systematically reviewed with retrieval types. Some criteria were used to filter the studies. Only studies published in English, that made a comparison between GeneXpert enterovirus assay and RT-PCR, and could be formulated in a 2*2 table, were included. The quality of the included studies was evaluated by QUADAS-2. The effect of the GeneXpert enterovirus assay was assessed by the Sensitivity, Specificity, Positive Likelihood Ratio, Negative Likelihood Ratio, Diagnosis Odds Ratio, and summary receiver operating characteristic (SROC) curve. Publication bias and heterogeneity were evaluated by the Deeks' funnel test and Bivariate Box plot respectively. Results 7 studies were recruited in the analysis. The Pooled Sensitivity was 0.96 [95% CI (0.94–0.97)], Pooled Specificity was 0.99 [95% CI (0.98–0.99)], Positive Likelihood Ratio was 130.46 [95% CI (35.79–475.58)], Negative Likelihood Ratio was 0.04 [95% CI (0.02–0.10)], and Diagnostic Odds Ratio was 3648.23 (95% CI [963.99–13,806.72)]. In SROC Curve, Area Under Curve (AUC) was 0.9980, and Q*= 0.9849. In Deeks' funnel test, the P-value was 0.807 (P > 0.05), indicating no publication bias. The Bivariate Box plot indicated no evident heterogeneity. Conclusions The GeneXpert enterovirus assay demonstrated high diagnostic accuracy in diagnosing enterovirus meningitis. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-022-00517-3.
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Affiliation(s)
- Min Lin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Chinese and Western Medicine in Clinical Medicine, The Clinical School of Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yun-Ran Li
- Department of Chinese and Western Medicine in Clinical Medicine, The Clinical School of Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qi-Wen Lan
- Department of Medical Imageology, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Li-Jun Long
- Department of Medical Laboratory Technology, The KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jia-Qi Liu
- Department of Chinese and Western Medicine in Clinical Medicine, The Clinical School of Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ying-Wen Chen
- Department of Chinese and Western Medicine in Clinical Medicine, The Clinical School of Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Xun-Jie Cao
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Ge-Yuan Wu
- Department of Chinese and Western Medicine in Clinical Medicine, The Clinical School of Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ya-Ping Li
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Laboratory Medicine, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
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Braunova A, Krbkova L, Rainetova P, Musilek M, Capovova I, Klapacova L, Musil V, Homola L, Kravalova T, Bednarova J, Kyr M. Clinical and laboratory characteristics of enteroviral meningitis in children, including qRT-PCR and sequencing analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:355-361. [DOI: 10.5507/bp.2018.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/18/2018] [Indexed: 11/23/2022] Open
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Alonso Pérez N, Sagastizabal Cardelus B, Prieto Tato LM, Guillén Martín S, González Torralba A, García Bermejo I, Ramos Amador JT. Evaluation of an Xpert EV (Cepheid ® ) molecular diagnostic technique for enteroviral meningitis. An Pediatr (Barc) 2017. [DOI: 10.1016/j.anpede.2016.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Alonso Pérez N, Sagastizabal Cardelus B, Prieto Tato LM, Guillén Martín S, González Torralba A, García Bermejo I, Ramos Amador JT. [Evaluation of an Xpert EV (Cepheid ®) molecular diagnostic technique for enteroviral meningitis]. An Pediatr (Barc) 2016; 87:201-205. [PMID: 27919639 DOI: 10.1016/j.anpedi.2016.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/19/2016] [Accepted: 09/26/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Polymerase chain reaction (PCR) assays have shown to be useful and quick for the diagnosis of enterovirus in aseptic meningitis. The aim of our study was to analyse the changes in clinical practice after the introduction of a real-time polymerase chain reaction (RT-PCR) technique using the Xpert EV (Cepheid®) assay for the qualitative detection of enterovirus RNA in cerebrospinal fluid specimens from children with suspected viral meningitis. METHODS A retrospective study was performed in children older than 1year, diagnosed with enterovirus meningitis in a third level hospital from November 2006 to February 2013. The first period, before the availability of Xpert EV (Cepheid®) (Group1, November 2006-August 2010) was compared with the later period (Group2, September 2010-February 2013). Clinical characteristics, the mean length of stay, and the cost per inpatient cases, were compared between the 2periods. RESULTS Forty-one patients (60.9% male) were included, with a median age of 64 months (interquartile range 28-96). Twenty-six patients (63.4%) were included in Group2. There were non-statistically significant differences in the epidemiological, disease severity, and laboratory characteristics between both periods of study. A significant difference was observed in the mean length of stay, with it being shorter in Group2 (48hours vs 40.5hours, P=.039), and a significant lower inpatient cost per case (€779.77 vs €656.05, P<.05). CONCLUSION Xpert EV (Cepheid®) assay was useful for decreasing the length of hospital stay and the costs associated with hospitalisation in children with enterovirus meningitis.
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Affiliation(s)
- Natalia Alonso Pérez
- Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España.
| | | | | | - Sara Guillén Martín
- Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España; Hospital Universitario de Getafe, Getafe, Madrid, España
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Wei L, Qiong Z, Xiao-ting S, Yu-jie L, Jian-hua M, Qiang S, Shi-qiang S. Molecular epidemiological study of enteroviruses associated with encephalitis in children from Hangzhou, China. Medicine (Baltimore) 2016; 95:e4870. [PMID: 27749541 PMCID: PMC5059043 DOI: 10.1097/md.0000000000004870] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 08/19/2016] [Accepted: 08/23/2016] [Indexed: 01/02/2023] Open
Abstract
Enterovirus (EV) has over 100 serotypes of species A-D, which can cause various symptoms in infants. Enterovirus encephalitis (EVE) is serve disease with high morbidity and mortality in children. To well define the epidemiology of EVE, we wanted to know more about EV and EV molecular typing by conducting this study in Hangzhou.Cerebrospinal fluid samples were collected from children with diagnosis of encephalitis. Meanwhile, one-step real-time RT-PCR was used for the detection of EV, and we also identified the serotypes of EV by using gene sequencing of VP1 or 5'UTR region.A total of 126 CSF specimens were tested and EV was detected in 26 specimens (20.6%). The molecular typing results showed different types of EV strains including Coxsackievirus B2, Coxsackievirus B3, Echovirus 5, Echovirus 16, Echovirus 18, Echovirus 30, and all EV isolates belonging to the human EV species B.According to the sequence of VP1 and 5'UTR region, E30 may be major cause of children's EVE in Hangzhou, China.
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Affiliation(s)
| | | | | | | | | | | | - Shang Shi-qiang
- Department of Clinical Laboratory, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China
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Angulo López I, González Escartín E, Aguirre Quiñonero A, Ots Ruiz E. [Simultaneous pneumococcal and enterovirus meningitis in an infant]. Enferm Infecc Microbiol Clin 2016; 35:128-130. [PMID: 27296437 DOI: 10.1016/j.eimc.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Itziar Angulo López
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Cantabria, España.
| | - Esther González Escartín
- Servicio de Pediatría, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Amaia Aguirre Quiñonero
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla - IDIVAL, Santander, Cantabria, España
| | - Elsa Ots Ruiz
- Servicio de Medicina Intensiva, Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
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Jeon JS, Kim JK, Yu J, Kim JW. Epidemic Trends of Enterovirus Infections From Pediatric Patients in Cheonan, Korea. J Clin Lab Anal 2014; 30:161-4. [PMID: 25425450 DOI: 10.1002/jcla.21830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 10/29/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a single hospital during recent 5 years. This study was preformed from December 2008 to November 2013. METHODS We subjected 1,067 cerebrospinal fluid (CSF) specimens from 1,053 patients and 678 stool specimens from 665 patients using real-time reverse-transcription polymerase chain reaction tests that could detect EV. The data were analyzed according to seasonality and patient age and sex. RESULTS During this period, 176 of the total 1,053 patients (16.81%) were positive for EV in CSF. The highest rate of EV-positive samples occurred in children less than 1 year of age (114/176, 64.77%), and the most prevalent month was June. The results for CSF and stool specimens were concordant in 545 (80.38%) of 678 cases. CONCLUSION We described the epidemiological analytic data of the EV in the population of Cheonan, South Korea. The combination of the CSF and stool specimen enhances the diagnostic yield. There is a need for continuous study of EV infections and its clinical manifestations.
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Affiliation(s)
- Jae-Sik Jeon
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jae Kyung Kim
- Department of Laboratory Medicine, Dankook University Hospital, Cheonan, Korea
| | - Jeesuk Yu
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Jong Wan Kim
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
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Dawood N, Desjobert E, Lumley J, Webster D, Jacobs M. Confirmed viral meningitis with normal CSF findings. BMJ Case Rep 2014; 2014:bcr-2014-203733. [PMID: 25035443 DOI: 10.1136/bcr-2014-203733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An 18-year-old woman presented with a progressively worsening headache, photophobia feverishness and vomiting. Three weeks previously she had returned to the UK from a trip to Peru. At presentation, she had clinical signs of meningism. On admission, blood tests showed a mild lymphopenia, with a normal C reactive protein and white cell count. Chest X-ray and CT of the head were normal. Cerebrospinal fluid (CSF) microscopy was normal. CSF protein and glucose were in the normal range. MRI of the head and cerebral angiography were also normal. Subsequent molecular testing of CSF detected enterovirus RNA by reverse transcriptase PCR. The patient's clinical syndrome correlated with her virological diagnosis and no other cause of her symptoms was found. Her symptoms were self-limiting and improved with supportive management. This case illustrates an important example of viral central nervous system infection presenting clinically as meningitis but with normal CSF microscopy.
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Carrasco Fernández JR, Gómez-Pastrana D, Alados Arboledas JC, Aragón Fernández C, Ortiz Tardío J. [Impact of introducing an enterovirus polymerase chain reaction in the management of aseptic meningitis]. An Pediatr (Barc) 2014; 82:e26-9. [PMID: 24856544 DOI: 10.1016/j.anpedi.2014.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/18/2014] [Accepted: 04/12/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The diagnosis of aseptic meningitis, based on an enterovirus PCR (EV-PCR) in cerebrospinal fluid, is a rapid and sensitive test. OBJECTIVE To assess the impact of introducing EV-PCR on the use of antibiotics and hospital length of stay in aseptic meningitis. MATERIAL AND METHODS A prospective study that included children with aseptic meningitis during one year. The patients prior to the introduction of the test formed the control group. RESULTS The performance of the PCR test was associated with less use of antibiotics compared to the control group (16.2% vs 41.4%, P=.029) and with fewer days of administration (.54 vs. 2 days, P=.014). A non-significant decrease in length of stay (3.57 vs. 4.21 days, P=.376) was also observed in the study group. CONCLUSION The introduction of the EV-PCR test decreases the use of antibiotics and hospital length of stay.
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Affiliation(s)
| | - D Gómez-Pastrana
- Servicio de Pediatría, Hospital General de Jerez de la Frontera, Cádiz, España
| | | | - C Aragón Fernández
- Servicio de Pediatría, Hospital General de Jerez de la Frontera, Cádiz, España
| | - J Ortiz Tardío
- Servicio de Pediatría, Hospital General de Jerez de la Frontera, Cádiz, España
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Detection and genotyping of enteroviruses in cerebrospinal fluid in patients in Victoria, Australia, 2007-2013. J Med Virol 2014; 86:1609-13. [DOI: 10.1002/jmv.23885] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 11/07/2022]
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Epidemiology of Aseptic Meningitis in Infants and Children (Shiraz - Iran). ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2012. [DOI: 10.5812/archcid.15086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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