1. Diagnostic performance of a multiplex PCR assay for meningitis in an HIV-infected population in Uganda.
- Author
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Rhein J, Bahr NC, Hemmert AC, Cloud JL, Bellamkonda S, Oswald C, Lo E, Nabeta H, Kiggundu R, Akampurira A, Musubire A, Williams DA, Meya DB, and Boulware DR
- Subjects
- Adult, CD4 Lymphocyte Count, Cohort Studies, Female, Humans, Immunocompromised Host, Male, Meningitis, Cryptococcal diagnosis, Meningitis, Cryptococcal microbiology, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Uganda, AIDS-Related Opportunistic Infections, Meningitis diagnosis, Meningitis microbiology, Multiplex Polymerase Chain Reaction methods, Multiplex Polymerase Chain Reaction standards
- Abstract
Meningitis remains a worldwide problem, and rapid diagnosis is essential to optimize survival. We evaluated the utility of a multiplex PCR test in differentiating possible etiologies of meningitis. Cerebrospinal fluid (CSF) from 69 HIV-infected Ugandan adults with meningitis was collected at diagnosis (n=51) and among persons with cryptococcal meningitis during therapeutic lumbar punctures (n=68). Cryopreserved CSF specimens were analyzed with BioFire FilmArray® Meningitis/Encephalitis panel, which targets 17 pathogens. The panel detected Cryptococcus in the CSF of patients diagnosed with a first episode of cryptococcal meningitis by fungal culture with 100% sensitivity and specificity and differentiated between fungal relapse and paradoxical immune reconstitution inflammatory syndrome in recurrent episodes. A negative FilmArray result was predictive of CSF sterility on follow-up lumbar punctures for cryptococcal meningitis. EBV was frequently detected in this immunosuppressed population (n=45). Other pathogens detected included: cytomegalovirus (n=2), varicella zoster virus (n=2), human herpes virus 6 (n=1), and Streptococcus pneumoniae (n=1). The FilmArray Meningitis/Encephalitis panel offers a promising platform for rapid meningitis diagnosis., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2016
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