TY - JOUR
T1 - Diagnostic performance of a multiplex PCR assay for meningitis in an HIV-infected population in Uganda
AU - Rhein, Joshua
AU - Bahr, Nathan C.
AU - Hemmert, Andrew C.
AU - Cloud, Joann L.
AU - Bellamkonda, Satya
AU - Oswald, Cody
AU - Lo, Eric
AU - Nabeta, Henry
AU - Kiggundu, Reuben
AU - Akampurira, Andrew
AU - Musubire, Abdu
AU - Williams, Darlisha A.
AU - Meya, David B.
AU - Boulware, David R.
AU - Ndyetukira, Jane Francis
AU - Ahimbisibwe, Cynthia
AU - Kugonza, Florence
AU - Velamakanni, Sruti S.
AU - Namudde, Alice
AU - Sadiq, Alisat
AU - Kandole, Tadeo Kiiza
AU - Kaboggoza, Julian
AU - Laker, Eva
AU - Luggya, Tony
AU - Tugume, Liliane
AU - Butler, Elissa
AU - Dyal, Jonathan
AU - Neborak, Julie
AU - King, Lexie
AU - Yueh, Nathan
AU - Hullsiek, Kathy Huppler
AU - Halupnick, Ryan
AU - Bohjanen, Paul R.
AU - Kambugu, Andrew
AU - ASTRO-CM Team
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
KW - Cryptococcal meningitis
KW - Diagnostics
KW - HIV
KW - Immunocompromised
KW - Meningitis
KW - PCR
UR - http://www.scopus.com/inward/record.url?scp=84958664133&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84958664133&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2015.11.017
DO - 10.1016/j.diagmicrobio.2015.11.017
M3 - Article
C2 - 26711635
AN - SCOPUS:84958664133
SN - 0732-8893
VL - 84
SP - 268
EP - 273
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 3
ER -
