Optimization of the Diagnosis of Central Nervous System Infections in Vietnamese Hospitals: Results From a Retrospective Multicenter Study.

Autor: Dong DV; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Boutin S; Institute of Medical Microbiology and Clinic for Infectious Diseases, University of Lübeck and University Medical Center Schleswig-Holstein, Lübeck, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany.; Airway Research Center North (ARCN), German Center for Lung Research (DZL), Lübeck, Germany., Sang VV; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Manh ND; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Hoan NX; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Quang HX; 103 Military Hospital, Hanoi, Vietnam., Lien TT; Viet Tiep Friendship Hospital, Haiphong, Vietnam.; Hai Phong University of Medicine and Pharmacy, Haiphong, Vietnam., Trang VD; National Hospital for Tropical Diseases, Hanoi, Vietnam., The NT; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Linh LTK; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Schmauder K; Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany.; German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany., Ueltzhöffer V; Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany., Hafza N; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany., Hauswaldt S; Institute of Medical Microbiology and Clinic for Infectious Diseases, University of Lübeck and University Medical Center Schleswig-Holstein, Lübeck, Germany., Rupp J; Institute of Medical Microbiology and Clinic for Infectious Diseases, University of Lübeck and University Medical Center Schleswig-Holstein, Lübeck, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany., Kremsner PG; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon., Song LH; 108 Military Central Hospital, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam., Nurjadi D; Institute of Medical Microbiology and Clinic for Infectious Diseases, University of Lübeck and University Medical Center Schleswig-Holstein, Lübeck, Germany.; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany., Peter S; Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany.; German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany., Velavan TP; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam.; German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany.; Faculty of Medicine, Duy Tan University, Danang, Vietnam.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Sep 13; Vol. 11 (9), pp. ofae531. Date of Electronic Publication: 2024 Sep 13 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae531
Abstrakt: Introduction: Central nervous system infections pose significant health challenges, particularly in low- and middle-income countries, because of high morbidity and mortality rates. Rapid and accurate diagnosis is essential for effective treatment to prevent adverse outcomes. Traditional culture-based diagnostics are often slow and lack specificity. This study evaluates the BioFire FilmArray Meningitis/Encephalitis (FAME) Panel against standard diagnostics in Vietnam to assess its clinical impact and suitability for local epidemiology.
Methods: We conducted a prospective study involving 330 patients with suspected central nervous system infections at 4 hospitals in northern Vietnam from July 2022 to April 2023. Cerebrospinal fluid samples were analyzed using routine culture methods and FAME. We compared pathogen detection rates and assessed the potential clinical impact of FAME results on patient management.
Results: Of the 330 cerebrospinal fluid specimens, 64 (19%) were positive by either conventional diagnostics (n = 48) and/or FAME (n = 33). The agreement between FAME and conventional diagnostics was 87%. Key pathogens Mycobacterium tuberculosis (n = 7), Klebsiella pneumoniae (n = 5), Streptococcus suis (n = 5), Epstein-Barr virus (n = 3), Acinetobacter baumannii (n = 1), and Trichosporon asahii (n = 1) were not detected by FAME. Classical meningitis parameter clinical symptoms, altered glucose, protein, and pleocytosis were good predictors of FAME positivity, indicating their utility in optimizing local diagnostic algorithms.
Conclusions: FAME complements traditional diagnostics by offering rapid and broad pathogen detection, crucial for timely and appropriate therapy. However, its effectiveness varies with local epidemiology, and it should not replace conventional methods entirely. Tailoring diagnostic panels to regional pathogen prevalence is recommended to enhance diagnostic accuracy and clinical outcomes in low- and middle-income countries.
Competing Interests: Potential conflicts of interest. All authors: No reported conflicts.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje