Etiology of Central Nervous System Infections in a Rural Area of Nepal Using Molecular Approaches
| Autor: | Paula Mölling, Lester Dornon, Nina Lagerqvist, Martin Sundqvist, Olof Säll, Marita Neander, Sabina Tiwari, Rabin Bom, Sara Thulin Hedberg |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Rural Population Adolescent viruses 030231 tropical medicine Dengue virus medicine.disease_cause Polymerase Chain Reaction Virus Young Adult 03 medical and health sciences 0302 clinical medicine Nepal Virology Streptococcus pneumoniae medicine Humans Child Aged Aged 80 and over Cryopreservation business.industry Varicella zoster virus Infant Bacterial Infections Cryptococcosis Articles Middle Aged Japanese encephalitis medicine.disease Infectious Diseases Herpes simplex virus Virus Diseases Child Preschool Cryptococcus neoformans Etiology Enterovirus Female Parasitology business |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | The etiology of infections of the central nervous system (CNS) in Nepal often remains unrecognized because of underdeveloped laboratory facilities. The aim of this study was to investigate the etiology of CNS infections in a rural area of Nepal using molecular methods. From November 2014 to February 2016, cerebrospinal fluid (CSF) was collected from 176 consecutive patients presenting at United Mission Hospital in Tansen, Nepal, with symptoms of possible CNS infection. After the CSF samples were stored and transported frozen, polymerase chain reaction (PCR) was performed in Sweden, targeting a total of 26 pathogens using the FilmArray® ME panel (BioFire, bioMerieux, Salt Lake City, UT), the MeningoFinder® 2SMART (PathoFinder, Maastricht, The Netherlands), and an in-house PCR test for dengue virus (DENV), Japanese encephalitis virus (JEV), and Nipah virus (NiV). The etiology could be determined in 23%. The bacteria detected were Haemophilus influenzae (n = 5), Streptococcus pneumoniae (n = 4), and Neisseria meningitidis (n = 1). The most common virus was enterovirus detected in eight samples, all during the monsoon season. Other viruses detected were cytomegalovirus (n = 6), varicella zoster virus (n = 5), Epstein–Barr virus (n = 3), herpes simplex virus (HSV) type 1 (HSV-1) (n = 3), HSV-2 (n = 3), human herpes virus (HHV) type 6 (HHV-6) (n = 3), and HHV-7 (n = 2). Cryptococcus neoformans/gatti was found in four samples. None of the samples were positive for DENV, JEV, or NiV. Of the patients, 67% had been exposed to antibiotics before lumbar puncture. In conclusion, the etiology could not be found in 77% of the samples, indicating that the commercial PCR panels used are not suitable in this setting. Future studies on the etiology of CNS infections in Nepal could include metagenomic techniques. |
| Databáze: | OpenAIRE |
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