1
|
Someko H, Okazaki Y, Tsujimoto Y, Ishikane M, Kubo K, Kakehashi T. Diagnostic accuracy of rapid antigen tests in cerebrospinal fluid for pneumococcal meningitis: a systematic review and meta-analysis. Clin Microbiol Infect 2023; 29:310-319. [PMID: 36503113 DOI: 10.1016/j.cmi.2022.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Streptococcus pneumoniae is a leading cause of bacterial meningitis worldwide. Conventional microbiological assays take several days and require the use of various drugs for empirical treatment. Rapid antigen tests in cerebrospinal fluid (CSF) may be useful to triage pneumococcal meningitis immediately. OBJECTIVES To elucidate whether rapid antigen tests in CSF are useful in the triage of pneumococcal meningitis. METHODS Data sourcesCochrane CENTRAL, MEDLINE, EMBASE, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov databases were searched. Study eligibility criteriaAll types of cohort studies except multiple-group studies, where the sensitivity and specificity of rapid antigen tests in CSF compared with CSF culture can be extracted. ParticipantsPatients with suspected meningitis. TestsRapid antigen tests in CSF. Reference standardsOne or more of the following: blood culture, CSF culture, and polymerase chain reaction in CSF. Assessment of risk of biasThe methodological quality of the included studies was assessed using QUADAS-2. Methods of data synthesisWe used a random-effects bivariate model for the meta-analysis. We conducted a subgroup analysis by dividing studies into types of antigen tests, adults and children, low-income and high-income countries, and with or without exposure to antibiotics before lumbar puncture. RESULTS Forty-four studies involving 14 791 participants were included. Most studies had a moderate-to-low methodological quality. Summary sensitivity and specificity were 99.5% (95% confidence interval (CI), 92.4-100%) and 98.2% (95% CI, 96.9-98.9%), respectively. Positive predictive values and negative predictive values at the median prevalence (4.2%) in the included studies were 70.8% (95% CI, 56.6-79.9%) and 100% (95% CI, 99.7-100%), respectively. The diagnostic accuracy was consistent across the various subgroups, except for slightly reduced sensitivity in high-income countries. CONCLUSIONS Rapid antigen tests in CSF would be useful in triaging pneumococcal meningitis. Further studies are warranted to investigate the clinical benefit of ruling out pneumococcal meningitis based on the results of rapid antigen tests.
Collapse
Affiliation(s)
- Hidehiro Someko
- Department of General Internal Medicine, Asahi General Hospital, Asahi, Japan.
| | - Yuji Okazaki
- Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Motomachi, Naka-ku, Hiroshima City, Hiroshima, Japan; Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yasushi Tsujimoto
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Nephrology and Dialysis, Kyoritsu Hospital, Kawanishi, Japan; Department of Health Promotion and Human Behavior, Kyoto University Graduate, School of Medicine/School of Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Tokyo, Japan
| | - Kenji Kubo
- Department of Infectious Diseases and Department of Emergency Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | | |
Collapse
|
2
|
Ahmed MA, Askar GA, Farghaly HS, Ahmed AO, Kamal DT, Ahmed SS, Mohamad IL. Evaluation of the accuracy of multiplex polymerase chain reaction in differentiation between bacterial and viral meningitis. Ir J Med Sci 2023; 192:403-407. [PMID: 35338445 PMCID: PMC9892078 DOI: 10.1007/s11845-022-02983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/14/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Meningitis is one of the most dangerous infection affecting children. The need for rapid and accurate diagnosis is mandatory for improving the outcome. AIM OF THE WORK To evaluate the role of multiplex polymerase chain reaction (PCR) in diagnosis of meningitis either bacterial or viral and to detect its accuracy. PATIENTS AND METHODS A cross-sectional study was carried out in University Children Hospital, Faculty of Medicine, between November 2019 and September 2020. The study was approved by the Ethics Review Board of Faculty of Medicine, Assiut University, and informed written consent was obtained. The committee's reference number is 17200161. Clinicaltrails.gov ID: NCT03387969. Forty-eight children aged 2 to 18 years with meningitis were included. Detailed history and examination, blood glucose level at time of admission prior to lumbar puncture, and multiplex PCR in cerebrospinal fluid (CSF) were evaluated. RESULTS The mean age of children was 3.27 ± 1.27 years. Thirty-five (72.9%) cases were bacterial meningitis while 13 (27.1%) cases were viral meningitis. Multiplex PCR had 94% sensitivity and 100% specificity for diagnosis of bacterial meningitis. CONCLUSION Multiplex PCR may help in diagnosis and differentiation of bacterial and viral meningitis with accurate and rapid results.
Collapse
Affiliation(s)
- Mahmoud Abdelfattah Ahmed
- grid.252487.e0000 0000 8632 679XPediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Gamal A. Askar
- grid.252487.e0000 0000 8632 679XPediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Hekma S. Farghaly
- grid.252487.e0000 0000 8632 679XPediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Asmaa O. Ahmed
- grid.252487.e0000 0000 8632 679XClinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Dalia T. Kamal
- grid.252487.e0000 0000 8632 679XClinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Shorook S. Ahmed
- grid.252487.e0000 0000 8632 679XMedical Student, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| | - Ismail L. Mohamad
- grid.252487.e0000 0000 8632 679XPediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516 Egypt
| |
Collapse
|
3
|
Cerebrospinal Fluid Leucine-Rich Alpha-2 Glycoprotein (LRG) Levels in Children with Acute Bacterial Meningitis. Indian J Pediatr 2022; 89:192-194. [PMID: 34741254 DOI: 10.1007/s12098-021-03972-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/03/2021] [Indexed: 10/19/2022]
Abstract
This study evaluated the diagnostic role of cerebrospinal fluid leucine-rich alpha-2 glycoprotein (CSF LRG) concentration in children with acute bacterial meningitis, and its role in differentiation from aseptic meningitis. CSF LRG concentration was measured by ELISA Kit of 50 children with bacterial meningitis, 16 aseptic meningitis, and 20 children with normal CSF; control. CSF LRG was significantly elevated (p < 0.001) in bacterial meningitis with a sensitivity, specificity, PPV, and NPV of 96%, 100%, 100%, and 90.9%, respectively at a cutoff of 110.0 ng/mL, based on ROC curve. At the same cutoff value, CSF LRG has sensitivity, specificity, PPV, and NPV of 96%, 75%, 92.3%, and 85.7%, respectively in differentiating bacterial from aseptic meningitis. However, sensitivity, specificity, PPV, and NPV at 139.9 ng/mL for differentiating between definite and probable bacterial meningitis were 88%, 75%, 79.1%, and 84.9%, respectively. CSF LRG should be used as a diagnostic biomarker for bacterial meningitis.
Collapse
|
4
|
Bremer M, Kadernani YE, Wasserman S, Wilkinson RJ, Davis AG. Strategies for the diagnosis and management of meningitis in HIV-infected adults in resource limited settings. Expert Opin Pharmacother 2021; 22:2053-2070. [PMID: 34154509 DOI: 10.1080/14656566.2021.1940954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The incidence of human immunodeficiency virus-1 (HIV-1) associated meningitis has been declining in the post-combination antiretroviral treatment (ART) era, although survival rates remain low for the common causes like tuberculosis and cryptococcal disease. Diagnosis and treatment of meningitis in HIV-1 is complicated by atypical clinical presentations, limited accuracy of diagnostic tests, access to diagnostic tests, and therapeutic agents in low- and middle-income countries (LMIC) and immune reconstitution inflammatory syndrome (IRIS). AREAS COVERED We provide an overview of the common etiologies of meningitis in HIV-1-infected adults, suggest a diagnostic approach based on readily available tests, and review specific chemotherapeutic agents, host-directed therapies, supportive care, timing of ART initiation, and considerations in the management of IRIS with a focus on resource-limited settings. They identify key knowledge gaps and suggest areas for future research. EXPERT OPINION Evidence-based management of HIV-1-associated meningitis is sparse for common etiologies. More readily available and sensitive diagnostic tests as well as standardized investigation strategies are required in LMIC. There is a lack of availability of recommended drugs in areas of high HIV-1 prevalence and a limited pipeline of novel chemotherapeutic agents. Host-directed therapies have been inadequately studied.
Collapse
Affiliation(s)
- Marise Bremer
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory
| | - Yakub E Kadernani
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory
| | - Sean Wasserman
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory.,Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Republic of South Africa
| | - Robert J Wilkinson
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory.,Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Republic of South Africa.,Department of Infectious Diseases, Imperial College London, London, UK.,Francis Crick Institute, London, UK.,Faculty of Life Sciences, University College London, London, UK
| | - Angharad G Davis
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory.,Francis Crick Institute, London, UK.,Faculty of Life Sciences, University College London, London, UK
| |
Collapse
|
5
|
Boni-Cisse C, Jarju S, Bancroft RE, Lepri NA, Kone H, Kofi N, Britoh-Mlan A, Zaba FS, Usuf E, Ndow PS, Worwui A, Mwenda JM, Biey JN, Ntsama B, Kwambana-Adams BA, Antonio M. Etiology of Bacterial Meningitis Among Children <5 Years Old in Côte d'Ivoire: Findings of Hospital-based Surveillance Before and After Pneumococcal Conjugate Vaccine Introduction. Clin Infect Dis 2020; 69:S114-S120. [PMID: 31505624 PMCID: PMC6761318 DOI: 10.1093/cid/ciz475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Bacterial meningitis remains a major disease affecting children in Côte d’Ivoire. Thus, with support from the World Health Organization (WHO), Côte d’Ivoire has implemented pediatric bacterial meningitis (PBM) surveillance at 2 sentinel hospitals in Abidjan, targeting the main causes of PBM: Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus). Herein we describe the epidemiological characteristics of PBM observed in Côte d’Ivoire during 2010–2016. Methods Cerebrospinal fluid (CSF) was collected from children aged <5 years admitted to the Abobo General Hospital or University Hospital Center Yopougon with suspected meningitis. Microbiology and polymerase chain reaction (PCR) techniques were used to detect the presence of pathogens in CSF. Where possible, serotyping/grouping was performed to determine the specific causative agents. Results Overall, 2762 cases of suspected meningitis were reported, with CSF from 39.2% (1083/2762) of patients analyzed at the WHO regional reference laboratory in The Gambia. In total, 82 (3.0% [82/2762]) CSF samples were positive for bacterial meningitis. Pneumococcus was the main pathogen responsible for PBM, accounting for 69.5% (52/82) of positive cases. Pneumococcal conjugate vaccine serotypes 5, 18C, 19F, and 6A/B were identified post–vaccine introduction. Emergence of H. influenzae nontypeable meningitis was observed after H. influenzae type b vaccine introduction. Conclusions Despite widespread use and high coverage of conjugate vaccines, pneumococcal vaccine serotypes and H. influenzae type b remain associated with bacterial meningitis among children aged <5 years in Côte d’Ivoire. This reinforces the need for enhanced surveillance for vaccine-preventable diseases to determine the prevalence of bacterial meningitis and vaccine impact across the country.
Collapse
Affiliation(s)
- Catherine Boni-Cisse
- Département de Microbiologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire;, UFR des Sciences Médicales.,Sentinel Site Surveillance Laboratory of Paediatric Bacterial Meningitis and Rotavirus Diarrhoea, Centre Hospitalier Universitair de Yopougon, Abidjan, Côte d'Ivoire
| | - Sheikh Jarju
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Rowan E Bancroft
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Nicaise A Lepri
- Département de Microbiologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire;, UFR des Sciences Médicales
| | - Hamidou Kone
- Département de Microbiologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire;, UFR des Sciences Médicales
| | - N'zue Kofi
- WHO Country Office, Abidjan, Côte d'Ivoire
| | - Alice Britoh-Mlan
- Sentinel Site Surveillance Laboratory of Paediatric Bacterial Meningitis and Rotavirus Diarrhoea, Centre Hospitalier Universitair de Yopougon, Abidjan, Côte d'Ivoire
| | - Flore Sandrine Zaba
- Sentinel Site Surveillance Laboratory of Paediatric Bacterial Meningitis and Rotavirus Diarrhoea, Centre Hospitalier Universitair de Yopougon, Abidjan, Côte d'Ivoire
| | - Effua Usuf
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Peter Sylvanus Ndow
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Archibald Worwui
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Jason M Mwenda
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Joseph N Biey
- WHO Intercountry Support Team, Ouagadougou, Burkina Faso
| | - Bernard Ntsama
- WHO Intercountry Support Team, Ouagadougou, Burkina Faso
| | - Brenda A Kwambana-Adams
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Martin Antonio
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia.,Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| |
Collapse
|
6
|
Tsolenyanu E, Bancroft RE, Sesay AK, Senghore M, Fiawoo M, Akolly D, Godonou MA, Tsogbale N, Tigossou SD, Tientcheu L, Dagnra A, Atakouma Y, Sylvanus Ndow P, Worwui A, Landoh DE, Mwenda JM, Biey JN, Ntsama B, Kwambana-Adams BA, Antonio M. Etiology of Pediatric Bacterial Meningitis Pre- and Post-PCV13 Introduction Among Children Under 5 Years Old in Lomé, Togo. Clin Infect Dis 2020; 69:S97-S104. [PMID: 31505623 PMCID: PMC6761369 DOI: 10.1093/cid/ciz473] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Pediatric bacterial meningitis (PBM) causes severe morbidity and mortality within Togo. Thus, as a member of the World Health Organization coordinated Invasive Bacterial Vaccine Preventable Diseases network, Togo conducts surveillance targeting Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, at a sentinel hospital within the capital city, Lomé, in the southernmost Maritime region. Methods Cerebrospinal fluid was collected from children <5 years with suspected PBM admitted to the Sylvanus Olympio Teaching Hospital. Phenotypic detection of pneumococcus, meningococcus, and H. influenzae was confirmed through microbiological techniques. Samples were shipped to the Regional Reference Laboratory to corroborate results by species-specific polymerase chain reaction. Results Overall, 3644 suspected PBM cases were reported, and 98 cases (2.7%: 98/3644) were confirmed bacterial meningitis. Pneumococcus was responsible for most infections (67.3%: 66/98), followed by H. influenzae (23.5%: 23/98) and meningococcus (9.2%: 9/98). The number of pneumococcal meningitis cases decreased by 88.1% (52/59) postvaccine introduction with 59 cases from July 2010 to June 2014 and 7 cases from July 2014 to June 2016. However, 5 cases caused by nonvaccine serotypes were observed. Fewer PBM cases caused by vaccine serotypes were observed in infants <1 year compared to children 2–5 years. Conclusions Routine surveillance showed that PCV13 vaccination is effective in preventing pneumococcal meningitis among children <5 years of age in the Maritime region. This complements the MenAfriVac vaccination against meningococcal serogroup A to prevent meningitis outbreaks in the northern region of Togo. Continued surveillance is vital for estimating the prevalence of PBM, determining vaccine impact, and anticipating epidemics in Togo.
Collapse
Affiliation(s)
- Enyonam Tsolenyanu
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
- Correspondence: E. Tsolenyanu, Department of Paediatrics Sylvanus Olympio University Hospital Center, National Coordinator for New Vaccines Surveillance, Lomé, Togo ()
| | - Rowan E Bancroft
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Abdul K Sesay
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Madikay Senghore
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Mawouto Fiawoo
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Djatougbe Akolly
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Mawussi A Godonou
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Novissi Tsogbale
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Segla D Tigossou
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Leopold Tientcheu
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Anoumou Dagnra
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Yawo Atakouma
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Peter Sylvanus Ndow
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Archibald Worwui
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | | | - Jason M Mwenda
- WHO Regional Office for Africa WHO/AFRO, Republic of Congo, Brazzaville
| | - Joseph N Biey
- WHO Intercountry Support Team West Africa, Ouagadougou, Burkina Faso
| | - Bernard Ntsama
- WHO Intercountry Support Team West Africa, Ouagadougou, Burkina Faso
| | - Brenda A Kwambana-Adams
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Martin Antonio
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
- Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| |
Collapse
|
7
|
Abstract
Infectious meningitis can be caused by viral, bacterial or fungal pathogens. Despite widely available treatments, many types of infectious meningitis are still associated with significant morbidity and mortality. Delay in diagnosis contributes to poor outcomes. Cerebrospinal fluid cultures have been used traditionally but are time intensive and sensitivity is decreased by empiric treatment prior to culture. More rapid techniques such as the cryptococcal lateral flow assay (IMMY), GeneXpert MTB/Rif Ultra (Cepheid) and FilmArray multiplex-PCR (Biofire) are three examples that have drastically changed meningitis diagnostics. This review will discuss a holistic approach to diagnosing bacterial, mycobacterial, viral and fungal meningitis.
Collapse
Affiliation(s)
- Victoria Poplin
- Department of Medicine, University of Kansas, Kansas City, KS 66160, USA
| | - David R Boulware
- Division of Infectious Diseases & International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Nathan C Bahr
- Division of Infectious Diseases, Department of Medicine, University of Kansas, Kansas City, KS 66160, USA
| |
Collapse
|
8
|
Emerging multidrug resistance isolates of hospital-acquired bacterial meningitis in a tertiary care centre in North India. J Med Microbiol 2019; 68:1585-1590. [DOI: 10.1099/jmm.0.001072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
|
9
|
Albuquerque RC, Moreno ACR, Dos Santos SR, Ragazzi SLB, Martinez MB. Multiplex-PCR for diagnosis of bacterial meningitis. Braz J Microbiol 2019; 50:435-443. [PMID: 30796713 PMCID: PMC6863191 DOI: 10.1007/s42770-019-00055-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022] Open
Abstract
Considering the great lethality and sequels caused by meningitis, rapid diagnosis and prompt treatment initiation have a great impact on patient outcome. Here, we developed a multiplex-PCR for simultaneous detection of the four most prevalent bacterial pathogens directly in CSF samples. The multiplex-PCR was designed to detect the following genes: fbsA (Streptococcus agalactiae), lytA (Streptococcus pneumoniae), crtA (Neisseria meningitidis), p6 (Haemophilus influenzae), and 16S rRNA (any bacterial agent). The multiplex-PCR showed a DNA detection limit of 1 pg/μL. Among 447 CSF samples tested, 40 were multiplex-PCR positive, in which 27 and 13 had positive and negative bacterial culture, respectively. Our multiplex-PCR is fast, reliable, and easily implementable into a laboratory routine for bacterial meningitis confirmation, especially for patients who previously started antimicrobial therapy. Our molecular approach can substantially improve clinical diagnosis and epidemiological measures of meningitis disease burden.
Collapse
Affiliation(s)
- Renata Chaves Albuquerque
- Faculdade de Ciências Farmacêuticas, Department of Clinical Chemistry and Toxicology, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ana Carolina Ramos Moreno
- Faculdade de Ciências Farmacêuticas, Department of Clinical Chemistry and Toxicology, Universidade de São Paulo (USP), São Paulo, Brazil.
- Biomedical Sciences Institute, Vaccine Development Laboratory, Department of Microbiology, USP, São Paulo, Brazil.
| | | | | | - Marina Baquerizo Martinez
- Faculdade de Ciências Farmacêuticas, Department of Clinical Chemistry and Toxicology, Universidade de São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
10
|
Amidu N, Antuamwine BB, Addai-Mensah O, Abdul-Karim A, Stebleson A, Abubakari BB, Abenyeri J, Opoku AS, Nkukah JE, Najibullah AS. Diagnosis of bacterial meningitis in Ghana: Polymerase chain reaction versus latex agglutination methods. PLoS One 2019; 14:e0210812. [PMID: 30653582 PMCID: PMC6336253 DOI: 10.1371/journal.pone.0210812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/02/2019] [Indexed: 01/01/2023] Open
Abstract
Bacterial meningitis is a public health crisis in the northern part of Ghana, where it contributes to very high mortality and morbidity rates. Early detection of the causative organism will lead to better management and effective treatment. Our aim was to evaluate the diagnostic accuracy of Pastorex and Wellcogen latex agglutination tests for the detection of bacterial meningitis in a resource-limited setting. CSF samples from 330 suspected meningitis patients within the northern zone of Ghana were analysed for bacterial agents at the zonal Public Health Reference Laboratory in Tamale using polymerase chain reaction (PCR) and two latex agglutination test kits; Pastorex and Wellcogen. The overall positivity rate of samples tested for bacterial meningitis was 46.4%. Streptococcus pneumoniae was the most common cause of bacterial meningitis within the sub-region, with positivity rate of 25.2%, 28.2% and 28.8% when diagnosed using Wellcogen, Pastorex and PCR respectively. The Pastorex method was 97.4% sensitive while the Wellcogen technique was 87.6% sensitive. Both techniques however produced the same specificity of 99.4%. Our study revealed that the Pastorex method has a better diagnostic value for bacterial meningitis than the Wellcogen method and should be the method of choice in the absence of PCR.
Collapse
MESH Headings
- Adolescent
- Adult
- Bacterial Typing Techniques
- Child
- Child, Preschool
- Female
- Ghana
- Humans
- Latex Fixation Tests/methods
- Male
- Meningitis, Bacterial/cerebrospinal fluid
- Meningitis, Bacterial/diagnosis
- Meningitis, Bacterial/microbiology
- Meningitis, Haemophilus/cerebrospinal fluid
- Meningitis, Haemophilus/diagnosis
- Meningitis, Haemophilus/microbiology
- Meningitis, Meningococcal/cerebrospinal fluid
- Meningitis, Meningococcal/diagnosis
- Meningitis, Meningococcal/microbiology
- Meningitis, Pneumococcal/cerebrospinal fluid
- Meningitis, Pneumococcal/diagnosis
- Meningitis, Pneumococcal/microbiology
- Predictive Value of Tests
- ROC Curve
- Real-Time Polymerase Chain Reaction
- Reproducibility of Results
- Serotyping
- Streptococcal Infections/cerebrospinal fluid
- Streptococcal Infections/diagnosis
- Streptococcal Infections/microbiology
- Streptococcus agalactiae/genetics
- Streptococcus agalactiae/isolation & purification
- Young Adult
Collapse
Affiliation(s)
- Nafiu Amidu
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
- * E-mail:
| | - Benedict Boateng Antuamwine
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Azure Stebleson
- Public Health Reference Laboratory, Northern Region, Tamale, Ghana
| | | | - John Abenyeri
- Northern Regional Health Directorate, Ghana Health Service, Tamale, Ghana
| | - Afia Serwaa Opoku
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - John Eyulaku Nkukah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Ali Sidi Najibullah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| |
Collapse
|
11
|
Orejarena Ávila LP, Inguilan Benavides EM, Padilla Sanabria L, Recalde-Reyes DP, Rodríguez-Salazar CA, Castaño-Osorio JC. Standardization of a latex agglutination test for coproantigen detection of Fasciola sp. in bovine cattle stool. J Parasit Dis 2018; 42:55-61. [PMID: 29491560 DOI: 10.1007/s12639-017-0964-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022] Open
Abstract
Fasciolosis is a zoonotic parasitic disease, which affects humans and animals; diagnosed through noncommercial immunoassay tests that cannot be used on the field. Thereby, establishing the optimal conditions to develop a latex agglutination technique with IgG and IgM antibodies directed against excretion/secretion antigens of Fasciola sp. is a priority. Latex particles were sensitized with IgG and IgM antibodies directed against excretion/secretion antigens of Fasciola sp. The specificity of the antibodies was determined against antigens of different helminths and protozoa; the sensitivity and specificity of the test was evaluated against a previously standardized direct ELISA. The coupling rates of the IgG and IgM antibodies were 85.77 and 100%, respectively. The minimum detectable concentration of Fasciola sp. excretion/secretion antigens, diluted in a phosphate-buffered saline, was 1.589 mg/mL(IgG) and 0.158 mg/mL(IgM) and for the antigens incorporated in the bovine cattle stool it was 3.178 mg/mL(IgG) and 1.589 mg/mL(IgM). The test showed crossed reaction against Giardia sp., and Cryptosporidium sp. antigens. Agreement of the IgG and IgM latex test against the ELISA test was of 78.78 and 96.96%, respectively; the specificity found was of 100% for both tests and sensitivity was 78.79% (IgG) and 96.97% (IgM). This work standardized the latex agglutination technique to detect Fasciola sp. antigens in bovine cattle stool.
Collapse
Affiliation(s)
- Lina Paola Orejarena Ávila
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| | - Erika Marcela Inguilan Benavides
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| | - Leonardo Padilla Sanabria
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| | - Delia Piedad Recalde-Reyes
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| | - Carlos Andrés Rodríguez-Salazar
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| | - Jhon Carlos Castaño-Osorio
- 1Grupo Inmunología Molecular (Gymol), Universidad del Quindío, Armenia, Quindío Colombia.,2Facultad Ciencias de la Salud, Universidad del Quindío, Carrera 15 Calle 12 Norte, Armenia, Quindío Colombia
| |
Collapse
|
12
|
Dunne EM, Mantanitobua S, Singh SP, Reyburn R, Tuivaga E, Rafai E, Tikoduadua L, Porter B, Satzke C, Strachan JE, Fox KK, Jenkins KM, Jenney A, Baro S, Mulholland EK, Kama M, Russell FM. Real-time qPCR improves meningitis pathogen detection in invasive bacterial-vaccine preventable disease surveillance in Fiji. Sci Rep 2016; 6:39784. [PMID: 28009001 PMCID: PMC5180226 DOI: 10.1038/srep39784] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/28/2016] [Indexed: 12/04/2022] Open
Abstract
As part of the World Health Organization Invasive Bacterial-Vaccine Preventable Diseases (IB-VPD) surveillance in Suva, Fiji, cerebrospinal fluid (CSF) samples from suspected meningitis patients of all ages were examined by traditional methods (culture, Gram stain, and latex agglutination for bacterial antigen) and qPCR for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Of 266 samples tested, pathogens were identified in 47 (17.7%). S. pneumoniae was the most common pathogen detected (n = 17) followed by N. meningitidis (n = 13). The use of qPCR significantly increased detection of IB-VPD pathogens (P = 0.0001): of 35 samples that were qPCR positive for S. pneumoniae, N. meningitidis, and H. influenzae, only 10 were culture positive. This was particularly relevant for N. meningitidis, as only 1/13 cases was culture positive. Molecular serotyping by microarray was used to determine pneumococcal serotypes from 9 of 16 (56%) of samples using DNA directly extracted from CSF specimens. Results indicate that qPCR significantly increases detection of S. pneumoniae, N. meningitidis, and H. influenzae in CSF, and that application of molecular diagnostics is a feasible way to enhance local and global surveillance for IB-VPD.
Collapse
Affiliation(s)
- Eileen M Dunne
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia
| | | | | | - Rita Reyburn
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia
| | | | - Eric Rafai
- Ministry of Health &Medical Services, Suva, Fiji
| | | | - Barbara Porter
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia
| | - Catherine Satzke
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.,The University of Melbourne, Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, Australia.,The University of Melbourne, Department of Paediatrics, Parkville, 3052, Australia
| | - Janet E Strachan
- The University of Melbourne, Microbiological Diagnostic Unit Public Health Laboratory, Melbourne, 3000, Australia
| | - Kimberly K Fox
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | | | - Adam Jenney
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.,Fiji National University, Department of Medical Science, College of Medicine, Nursing and Health Sciences, Suva, Fiji
| | - Silo Baro
- Ministry of Health &Medical Services, Suva, Fiji
| | - E Kim Mulholland
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.,London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, WC1E 7HT, UK
| | - Mike Kama
- Ministry of Health &Medical Services, Suva, Fiji
| | - Fiona M Russell
- Murdoch Childrens Research Institute, Infection and Immunity, Parkville, 3052, Australia.,The University of Melbourne, Department of Paediatrics, Parkville, 3052, Australia
| |
Collapse
|
13
|
JAROUSHA AMA, AFIFI A. Epidemiology and Risk Factors Associated with Developing Bacterial Meningitis among Children in Gaza Strip. IRANIAN JOURNAL OF PUBLIC HEALTH 2014; 43:1176-83. [PMID: 26175971 PMCID: PMC4500419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 07/11/2014] [Indexed: 11/01/2022]
Abstract
BACKGROUND Bacterial meningitis is still the leading cause of high morbidity and mortality among the children. The present study was conducted to determine the epidemiology, clinical characteristics of bacterial meningitis and to evaluate the risk factors associated with developing the infection. METHODS This cross sectional study was conducted in three hospitals of Gaza strip -Palestine during the period 2009. All the children with clinical diagnosis of meningitis /meningoencephalitis admitted to these hospitals were included in the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations. RESULTS During the period (2009), 1853 patients were admitted to the hospitals with suspect of meningitis by pediatricians, 73 (3.9%) proved by culture to be acute bacterial meningitis, of these patients 62% were males and 38% were females. The common isolated pathogens were Neisseria meningitides (47.9%), Streptococcus pneumonia (15.1%), Haemophilus influenza (13.7%), E. coli (11.0%), Enterobacter spp. (6.8%), Citrobacter spp. (2.7%), Providencia spp. (1.4%), and Pseudomonas aeruginosa (1.4%). The common recorded symptoms were fever (78%), neck stiffness (47%), vomiting (37%), poor feeding (19%), and irritability (16%). Statistical analysis showed that there was statistical significance associated developing of infection with malnutrition (low hemoglobin level), high house crowdness and irritability (P-value <0.05). The ANOVA statistical analysis showed that S. pneumonia has an impact on developing low hemoglobin level and leukocytosis. CONCLUSION N. meningitides is still dominant and needs vaccination. The risk factors should be taken into consideration in any future plan.
Collapse
Affiliation(s)
| | - Ahmed.Al AFIFI
- 2. Al Nasser Pediatric Hospital, Ministry of Health, Gaza, Palestine
| |
Collapse
|
14
|
Epidemiology and drug resistance profile of acute bacterial meningitis in children in Northern India: a university hospital perspective. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60734-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|