Comparison of Culture, Antigen Test, and Polymerase Chain Reaction for Pneumococcal Detection in Cerebrospinal Fluid of Children

Hasanuzzaman, Hasanuzzaman; Saha, Senjuti; Malaker, Roly; Rahman, Hafizur; Sajib, Mohammad Saiful Islam; Das, Rajib; Islam, Maksuda; Hamer, Davidson H.; Saha, Samir K.

doi:10.1093/infdis/jiab073

Cited by 4 publications

(3 citation statements)

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“…The use of antibiotics reduces the identification of pathogens at least by 30% [ 33 ]. Compared to culture, multiplex or quantitative PCR has shown up to two-fold better sensitivities and specificities up to 100% [ 31 , 33 ]. Our results of CSF culture positivity (33.8%) are compatible with previous studies, especially with frequently used pre-diagnostic antibiotics (57.4%).…”

Section: Discussionmentioning

confidence: 99%

Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland

et al. 2023

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Background Bacterial meningitis (BM) causes significant morbidity and mortality. We investigated predisposing factors, clinical characteristics, spectrum of etiological bacteria, and clinical outcome of community-acquired and nosocomial BM. Methods In this retrospective study we analyzed data of 148 adults (age > 16 years) with BM treated in Turku University Hospital, Southwestern Finland, from 2011 to 2018. Besides culture- or polymerase chain reaction (PCR)-positive cases we also included culture-negative cases with laboratory parameters strongly suggestive of BM and those with meningitis-related findings in imaging. We used Glasgow Outcome Scale (GOS) score 1–4 to determine unfavorable outcome. Results The median age of patients was 57 years and 48.6% were male. Cerebrospinal fluid (CSF) culture for bacteria showed positivity in 50 (33.8%) cases, although pre-diagnostic antibiotic use was frequent (85, 57.4%). The most common pathogens in CSF culture were Streptococcus pneumoniae (11, 7.4%), Staphylococcus epidermidis (7, 4.7%), Staphylococcus aureus (6, 4.1%) and Neisseria meningitidis (6, 4.1%). Thirty-nine patients (26.4%) presented with the triad of fever, headache, and neck stiffness. A neurosurgical procedure or an acute cerebral incident prior BM was recorded in 74 patients (50%). Most of the patients had nosocomial BM (82, 55.4%) and the rest (66, 44.6%) community-acquired BM. Ceftriaxone and vancomycin were the most used antibiotics. Causative pathogens had resistances against the following antibiotics: cefuroxime with a frequency of 6.8%, ampicillin (6.1%), and tetracycline (6.1%). The case fatality rate was 8.8% and the additional likelihood of unfavorable outcome 40.5%. Headache, decreased general condition, head computed tomography (CT) and magnetic resonance imaging (MRI), hypertension, altered mental status, confusion, operative treatment, neurological symptoms, pre-diagnostic antibiotic use and oral antibiotics on discharge were associated with unfavorable outcome. Conclusions The number of cases with nosocomial BM was surprisingly high and should be further investigated. The usage of pre-diagnostic antibiotics was also quite high. Headache was associated with unfavorable outcome. The frequency of unfavorable outcome of BM was 40.5%, although mortality in our patients was lower than in most previous studies.

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Section: Discussionmentioning

confidence: 99%

Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland

et al. 2023

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“…Thus, it is of great importance to identify the pathogenic microorganisms as rapidly as possible in order to guide treatment. However, blood culture has a low sensitivity in probing many microorganisms, which can detect bacterial/fungal culture and the culture cycle is long (Hasanuzzaman et al, 2021). Quantitative real-time polymerase chain reaction (qRT-PCR) is quick and convenient, but it can only detect specific, suspected pathogens.…”

Section: Introductionmentioning

confidence: 99%

Clinical application value of metagenomic second-generation sequencing technology in hematologic diseases with and without transplantation

Zhang

Wang

et al. 2023

Front. Cell. Infect. Microbiol.

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IntroductionHematological patients are at risk of infections. It is unknown whether the pathogenic microbial spectrum differs between HSCT and non-HSCT patients, and whether metagenomic next-generation sequencing (mNGS) of peripheral blood can be used as a substitute test specimen such as alveolar lavage.MethodsA retrospective study was conducted to evaluate the clinical application value of mNGS in hematological patients with and without HSCT.ResultsViruses were prevalent pathogens in both non-HSCT (44%) and HSCT (45%) patients, chiefly human cytomegalovirus and Epstein–Barr virus. In non-HSCT patients, Gram-negative bacilli accounted for 33% (predominantly Klebsiella pneumonia), and Gram-positive cocci accounted for 7% (predominantly Enterococcus faecium) of pathogens. However, in HSCT patients, Gram-negative bacilli accounted for 13% (predominantly Stenotrophomonas maltophilia), and Gram-positive cocci accounted for 24% (predominantly Streptococcus pneumonia) of pathogens. Mucor was the most common fungu s in two groups. The positive rate of pathogens by mNGS was 85.82%, higher than conventional detection (20.47%, P < 0.05). Mixed infection accounted for 67.00%, among which the mixed infection of bacteria and virus (25.99%) was the most common. 78 cases had pulmonary infection, the positive rate of traditional laboratory tests was 42.31% (33/78), and of mNGS in peripheral blood was 73.08% (57/78), showing a statistical difference (P = 0.000). The non-HSCT patients had a higher frequency of Klebsiella pneumonia (OR=0.777, 95% CI, 0.697-0.866, P = 0.01) and Torque teno virus (OR=0.883, 95% CI, 0.820-0.950, P = 0.031) infections than HSCT patients, while the rates of Streptococcus pneumonia (OR=12.828, 95% CI, 1.378-119.367, P = 0.016), Candida pseudosmooth (OR=1.100, 95% CI, 0.987-1.225, P = 0.016), human betaherpesvirus 6B (OR=6.345, 95% CI, 1.105-36.437, P = 0.039) and human polyomavirus 1 (OR=1.100, 95% CI, 0.987-1.225, P = 0.016) infections were lower. Leishmania could be detected by mNGS.ConclusionmNGS of peripheral blood can be used as a substitute test method for hematological patients with pulmonary infection, the detection rate of mixed infections by mNGS was high, and mNGS has high clinical recognition rate and sensitivity in pathogen detection, and provides a basis for guiding the anti-infective treatment in hematological diseases with symptoms such as fever.

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“…Additionally, culture test is the gold standard for the diagnosis of streptococcal pharyngitis [ 21 ]. Previous studies have performed immunochromatographic tests using Lateral flow assays to detect S. pneumoniae in cerebrospinal fluid [ 5 ] and S. agalactiae in vaginal swabs [ 17 ]. In particular, the immunochromatographic test was reported to be as sufficiently robust and accurate in detecting S. agalactiae as the traditional bacterial cultivation method [ 17 ].…”

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confidence: 99%

Performance evaluation of a rapid immunochromatographic test kit in detecting bovine mastitis-causing streptococci

TSUGAMI,

NAGASAWA,

SUGIYAMA

et al. 2024

The Journal of Veterinary Medical Science

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Mastitis causes significant economic losses to the dairy industry due to decreased milk production in infected cows. Identification of mastitis-causing pathogens, such as streptococci, is necessary for selecting an effective antibiotic for treating mastitis.Although bacterial cultivation is widely used for pathogen identification, it requires more than 24 hr to complete. Contrarily, Lateral flow assays are simple, rapid, and inexpensive testing procedures. In this study, the effectiveness of an immunochromatographic test kit for detecting streptococci in milk samples from cows with clinical mastitis was evaluated as an alternative to bacterial cultivation. The performance of the immunochromatographic test kit for detecting mastitis-causing pathogens was compared with that of bacterial cultivation and real-time quantitative polymerase chain reaction (qPCR). The sensitivity and specificity of the immunochromatographic test kit were 0.800 and 0.875, respectively, compared with bacterial cultivation. Additionally, the κ statistic values of the immunochromatographic test kit was 0.667, indicating substantial agreement with the results of bacterial cultivation. Statistically, sensitivity and specificity of the immunochromatographic kit and real-time qPCR did not differ significantly; thus, the immunochromatographic test kit detected mastitis-causing streptococci as effectively as real-time qPCR. Therefore, the immunochromatographic kit is a rapid, inexpensive, and 4 simple method for detecting streptococci and contributes to the timely selection of appropriate antibiotics for treatment and promotes early recovery from mastitis.

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Comparison of Culture, Antigen Test, and Polymerase Chain Reaction for Pneumococcal Detection in Cerebrospinal Fluid of Children

Cited by 4 publications

References 29 publications

Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland

Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland

Clinical application value of metagenomic second-generation sequencing technology in hematologic diseases with and without transplantation

Performance evaluation of a rapid immunochromatographic test kit in detecting bovine mastitis-causing streptococci

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