[评估 Bio-Speedy 脑膜炎/脑炎样本在诊断中枢神经系统感染中的作用]。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-07-01 DOI:10.5578/mb.202497189
Osman Merdan, İmran Sağlık, Fatma Dilşad Aksoy, Uğur Önal, Cüneyt Özakın, Mustafa Kemal Hacımustafaoğlu, Solmaz Çelebi, Harun Ağca, Mehmet Tekinsoy, Beyza Ener
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The panel can detect a range of pathogens, including Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae, enterovirus (EV), herpes simplex virus (HSV) 1 and 2, HHV-6, HHV-7, HHV-8, human parechovirus (HPeV), varicella zoster virus (VZV), cytomegalovirus (CMV) and Cryptococcus gatti/neoformans in CSF samples. This retrospective study included 128 CSF samples from 128 patients sent to Bursa Uludağ University Health Application and Research Center Microbiology Laboratory between June 2022 and July 2023 to search for CNS infectious agents. Patient clinical, radiological and laboratory data were collected from the Hospital Information Record System (HIRS). 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引用次数: 0

摘要

中枢神经系统(CNS)感染如果得不到准确诊断和治疗,可能会导致严重后果。中枢神经系统感染的病原体种类繁多,这给诊断带来了挑战。基于聚合酶链式反应(PCR)的多重分子诊断试剂盒可同时快速检测脑脊液(CSF)中的多种神经病原体。本研究旨在评估 Bio-Speedy 脑膜炎/脑炎 RT-PCR MX-17 检验板(Bioeksen,伊斯坦布尔,图尔基耶)在诊断中枢神经系统感染方面的作用。该试剂盒可检测一系列病原体,包括大肠杆菌 K1、流感嗜血杆菌、单核细胞增生李斯特菌、脑膜炎奈瑟菌、肺炎链球菌、无乳链球菌、肠道病毒 (EV)、疱疹病毒 (EV)、疱疹病毒 (EV)、肠道病毒 (EV)、单纯疱疹病毒 (HSV) 1 和 2、HHV-6、HHV-7、HHV-8、人类帕累托病毒 (HPeV)、水痘带状疱疹病毒 (VZV)、巨细胞病毒 (CMV) 和加蒂隐球菌/新变形隐球菌。这项回顾性研究纳入了 2022 年 6 月至 2023 年 7 月间送往布尔萨乌鲁达大学健康应用与研究中心微生物实验室的 128 例患者的 CSF 样本,以寻找中枢神经系统感染病原体。患者的临床、放射和实验室数据均来自医院信息记录系统(HIRS)。细菌病原体通过培养进行鉴定,病毒病原体则通过快速诊断公司(FTD)的多重 RT-PCR 小组(Fast Track Diagnostics Ltd., Luxembourg)对 CSF 样本中的 HSV-1、HSV-2、VZV、EV、腮腺炎病毒和 HPeV 进行检测。然后使用 BioSpeedy 检测板对储存的 CSF 样品进行检测,并将结果与培养和 FTD 检测板的结果进行比较。根据传染病专家和儿科传染病专家的意见,如果检测出的病原体与患者的症状和 CSF 特征相符,则认为是阳性病原体。检测到的病原体如果与患者症状和 CSF 特征不符,则被归类为临床相关性不确定(UCR)。在接受中枢神经系统感染病原体检测的 128 名患者中,有 44 人(34.4%)被确诊为中枢神经系统感染。所有方法的病原体总检出率为 43.2%(19/44)。Bio-Speedy小组在29.5%(13/44)的患者中发现了病原体,其次是FTD小组(20.5%,9/44)和培养(9.1%,4/44)。通过培养确定了四种细菌,其中三种也被 Bio-Speedy 小组检测到。此外,Bio-Speedy 鉴定小组还鉴定出 6 种细菌,但培养方法未鉴定出这些细菌。FTD 检测板检测出 9 种病毒,其中 4 种也被 Bio-Speedy 检测板检测出来。在 19 种阳性病原体中,Bio-Speedy 小组共检测出 13 种(9 种细菌和 4 种病毒):[肺炎双球菌(3 个)、VZV(3 个)、脑膜炎双球菌(2 个)、流感嗜血杆菌(2 个)、单核细胞增多性乳酸杆菌(1 个)、大肠杆菌(1 个)和 EV(1 个)]。然而,Bio-Speedy 鉴定小组确定了 15 种病原体[肺炎链球菌(n=1)、大肠杆菌(n=1)、卡地/新变形杆菌(n=1)、巨细胞病毒(n=8)、HHV-6(n=3)和 HHV-7 (n=1)]被认为是 UCR。在确诊的中枢神经系统感染患者中,Bio-Speedy 鉴定出致病病原体的比例最高(29.5%)。尽管如此,仍应根据患者的特征来解释检测结果,以确保对患者进行适当的管理。使用多种方法和多重检验可提高中枢神经系统感染的诊断准确性。
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[Evaluation of the Bio-Speedy Meningitis/Encephalitis Panel in the Diagnosis of Central Nervous System Infections].

Infections of the central nervous system (CNS) can lead to severe outcomes if not accurately diagnosed and treated. The broad spectrum of pathogens involved in CNS infections can make diagnosis challenging. Polymerase chain reaction (PCR) -based multiplex molecular diagnostic panels can rapidly and simultaneously detect multiple neuropathogens in cerebrospinal fluid (CSF). This study was aimed to assess the Bio-Speedy Meningitis/Encephalitis RT-PCR MX-17 panel (Bioeksen, İstanbul, Türkiye), a novel multiplex PCR test, in diagnosing CNS infections. The panel can detect a range of pathogens, including Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae, enterovirus (EV), herpes simplex virus (HSV) 1 and 2, HHV-6, HHV-7, HHV-8, human parechovirus (HPeV), varicella zoster virus (VZV), cytomegalovirus (CMV) and Cryptococcus gatti/neoformans in CSF samples. This retrospective study included 128 CSF samples from 128 patients sent to Bursa Uludağ University Health Application and Research Center Microbiology Laboratory between June 2022 and July 2023 to search for CNS infectious agents. Patient clinical, radiological and laboratory data were collected from the Hospital Information Record System (HIRS). Bacterial pathogens were identified through culture, while viral pathogens were detected in CSF samples using the Fast Track Diagnostics (FTD) multiplex RT-PCR panel (Fast Track Diagnostics Ltd., Luxembourg) for HSV-1, HSV-2, VZV, EV, mumps virus and HPeV. The stored CSF samples were then tested using the BioSpeedy panel and the results were compared with those of the culture and the FTD panel. Pathogens that were detected were considered positive if they were consistent with the patient's symptoms and CSF characteristics according to infectious disease and pediatric infectious disease specialists. Pathogens detected but not supported by the patient's symptoms and CSF characteristics were classified as uncertain clinical relevance (UCR). Out of the 128 patients tested for CNS infectious agents, 44 (34.4%) were diagnosed with a CNS infection. The overall pathogen detection rate with all methods was 43.2% (19/44). The Bio-Speedy panel identified pathogens in 29.5% (13/44) of the patients, followed by the FTD panel (20.5%, 9/44) and culture (9.1%, 4/44). Four bacteria were identified with culture, three of which were also detected by the Bio-Speedy panel. Additionally, six bacteria were identified with Bio-Speedy panel, that were not identified by culture. The FTD panel identified nine viruses, four of which were also identified by Bio-Speedy. In total, the Bio-Speedy panel detected 13 of the 19 positive pathogens (nine bacteria and four viruses: [S.pneumoniae (n= 3), VZV (n= 3), N.meningitidis (n= 2), H.influenzae (n= 2), L.monocytogenes (n= 1), E.coli (n= 1) ve EV (n= 1)]. However, the Bio-Speedy panel identified 15 pathogens [S.pneumoniae (n= 1), E.coli (n= 1), C.gatti/neoformans (n= 1), CMV (n= 8), HHV-6 (n= 3) ve HHV-7 (n= 1)] considered as UCR. The Bio-Speedy identified the causative pathogens in the highest percentage (29.5%) of patients with confirmed CNS infections. Nevertheless, test results should be interpreted based on patient characteristics to ensure appropriate patient management. Using multiple methods and multiplex tests may improve diagnostic accuracy for CNS infections.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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