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Fang M, Li S, Mao Z, Liu X, Wang X, Lu S. A retrospective study on intracranial mixed infection with tuberculous meningitis in Shenzhen, China. Microbiol Spectr 2024; 12:e0374723. [PMID: 38767391 PMCID: PMC11218455 DOI: 10.1128/spectrum.03747-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
Tuberculous meningitis (TBM) is a prevalent global intracranial infection and the most lethal and disabling form of tuberculosis. TBM with mixed intracranial infections is clinically rare but has a higher mortality rate. To investigate the clinical characteristics of TBM with mixed intracranial infections, demographic and clinical data of TBM and pulmonary tuberculosis (PTB) patients admitted to Shenzhen Third People's Hospital between January 2015 and October 2022 were collected anonymously. A total of 207 cases of TBM were diagnosed, of which 16 cases (7.73%) were TBM with mixed intracranial infections. The overall mortality rate of TBM cases was 16.4%, while the mortality rate of TBM cases with mixed intracranial infections was as high as 35.7%. Compared to simple TBM cases, TBM cases with mixed intracranial infections had severer clinical symptoms. The percentage of human immune deficiency virus (HIV)-positive TBM cases with mixed intracranial infections reached up to 68.8%. HIV co-infection, CD4+/CD8+ T-cell counts less than 1, cranial nerve impairment, paralysis, cerebral infarction, PRO less than 450 mg/L, WBC less than 10 × 106 /L, and CL more than 120 mmol/L were risk factors for TBM cases with mixed intracranial infections. Compared to PTB, HIV co-infection, CD4+ T cell less than 550 /uL, and age less than 45 years were risk factors for TBM, and TBM was associated with higher mortality rates. Our study provides additional data to better understand single TBM and TBM with mixed intracranial infections. More than two-thirds of TBM cases with mixed intracranial infections were HIV-positive. Clinicians should consider the possibility of multiple infections in people with TBM/HIV co-infection. IMPORTANCE TBM can cause severe neurological damage and death, and TBM with mixed intracranial infections can exacerbate the damage and poor prognosis of the disease. TBM with mixed intracranial infections is a rare disease, which has led to an incomplete understanding of its clinical features. This study investigated the clinical features of TBM and its associated factors by comparing the characteristics of TBM with mixed intracranial infections, single TBM and pulmonary tuberculosis. This information will help to improve the understanding of TBM, diagnostic accuracy and treatment outcomes.
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Affiliation(s)
- Mutong Fang
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Sinian Li
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Zhi Mao
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Xuhui Liu
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Xiaomin Wang
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Shuihua Lu
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
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Li JY, Chen XP, Tie YQ, Sun XL, Zhang RQ, He AN, Nie MZ, Fan GH, Li FY, Tian FY, Shen XX, Feng ZS, Ma XJ. Detection of low-load Epstein-Barr virus in blood samples by enriched recombinase aided amplification assay. AMB Express 2022; 12:71. [PMID: 35689713 PMCID: PMC9188631 DOI: 10.1186/s13568-022-01415-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Epstein-Barr virus (EBV), a common human γ-herpesvirus, infects more than 90% of adults worldwide. The purpose of this study was to establish a novel EBV detection method by combining the recombinase aided amplification (RAA) assay with an initial enrichment step that utilizes magnetic beads coated with a recombinant human mannan-binding lectin (rhMBL, M1 protein). An M1 protein–protein A magnetic bead complex (M1 beads) was prepared and used to achieve separation and enrichment of EBV from blood. After nucleic acid extraction, DNA was amplified by RAA. Using 388 whole blood samples and 1 serum sample, we explored the specificity, sensitivity and applicability of the newly developed detection method and compared it with commercial quantitative real-time polymerase chain reaction (qPCR) following M1 bead enrichment, traditional qPCR and traditional RAA. After enrichment, the positivity rate of EBV was increased from 15.94% to 17.74% by RAA (P < 0.05) and from 7.20% to 15.17% by qPCR (P < 0.05). The viral loads after enrichment were increased by 1.13 to 23.19-fold (P < 0.05). Our data demonstrates that an RAA assay incorporating M1 bead enrichment is a promising tool for detecting low EBV viral loads in blood samples that will facilitate an early response to EBV infection. The RAA with an enrichment step that utilizes magnetic beads coated with M1 protein. A very effective method for detecting low-load virus in blood samples. The first report describing virus detection using this method.
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Affiliation(s)
- Jing-Yi Li
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China.,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.,NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Xiao-Ping Chen
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Yan-Qing Tie
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China.,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China
| | - Xiu-Li Sun
- Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.,NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China.,North China University of Science and Technology, No. 46 West Xinhua Road, Tangshan, 063009, Hebei, China
| | - Rui-Qing Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - An-Na He
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China.,North China University of Science and Technology, No. 46 West Xinhua Road, Tangshan, 063009, Hebei, China
| | - Ming-Zhu Nie
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China.,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.,NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Guo-Hao Fan
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Feng-Yu Li
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China.,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.,NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Feng-Yu Tian
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China.,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.,NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China
| | - Xin-Xin Shen
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China.
| | - Zhi-Shan Feng
- Hebei Medical University, No. 361 East Zhongshan Road, Shijiazhuang, 050031, Hebei, China. .,Hebei General Hospital, No. 348 West Heping Road, Shijiazhuang, 050070, Hebei, China.
| | - Xue-Jun Ma
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, No. 155, Changbai Street, Changping District, Beijing, 102206, China.
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