Culture and Real-time Polymerase Chain reaction sensitivity in the diagnosis of invasive meningococcal disease: Does culture miss less severe cases?
| Autor: | Silvia Ricci, Giuseppe Indolfi, Francesco Nieddu, Alessandro Casini, Elisa De Vitis, Sara Guiducci, Maria Moriondo, Massimo Resti, Chiara Azzari, G.M. Poggi |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Bacterial Diseases
Male 0301 basic medicine Physiology Antibiotics Cell Culture Techniques Meningococcal Disease Neisseria meningitidis Pathology and Laboratory Medicine medicine.disease_cause Nervous System Severity of Illness Index Gastroenterology 0302 clinical medicine Cerebrospinal fluid Infectious Diseases of the Nervous System Biochemistry Genetics and Molecular Biology (all) Agricultural and Biological Sciences (all) Case fatality rate Medicine and Health Sciences 030212 general & internal medicine Child False Negative Reactions Cerebrospinal Fluid Multidisciplinary Antimicrobials Drugs Body Fluids Bacterial Pathogens Blood Infectious Diseases Real-time polymerase chain reaction Neurology Medical Microbiology Child Preschool Medicine Female Anatomy Pathogens Neisseria Meningitis Research Article DNA Bacterial medicine.medical_specialty Adolescent medicine.drug_class Science Inflammatory Diseases 030106 microbiology Meningitis Meningococcal Real-Time Polymerase Chain Reaction Meningococcal disease Microbiology Sensitivity and Specificity Sepsis Young Adult 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Microbial Control Internal medicine medicine Humans Microbial Pathogens Retrospective Studies Pharmacology Bacteria business.industry Organisms Infant Newborn Biology and Life Sciences Infant medicine.disease Bacterial Load business |
| Zdroj: | PLoS ONE PLoS ONE, Vol 14, Iss 3, p e0212922 (2019) |
| Popis: | BackgroundInvasive meningococcal disease (IMD) is a highly lethal disease. Diagnosis is commonly performed by culture or Realtime-PCR (qPCR).AimsOur aim was to evaluate, retrospectively, whether culture positivity correlates with higher bacterial load and fatal outcome. Our secondary aim was to compare culture and qPCR sensitivity.MethodsThe National Register for Molecular Surveillance was used as data source. Cycle threshold (CT), known to be inversely correlated with bacterial load, was used to compare bacterial load in different samples.ResultsThree-hundred-thirteen patients were found positive for Neisseria meningitidis by qPCR, or culture, or both; 41 died (case fatality rate 13.1%); 128/143 (89.5%) blood samples and 138/144 (95.8%) CSF were positive by qPCR, 37/143 (25.9%) blood samples and 45/144 (31.2%) CSF were also positive in culture. qPCR was 3.5 times (blood) or 3.1 times (CSF) more sensitive than culture in achieving a laboratory diagnosis of IMD (OR 24.4; 95% CI 12.2-49.8; p < .10-4; Cohen's κ 0.08 for blood and OR 49.0; 95% CI 19.1-133.4; pConclusionsIn conclusion our study demonstrated that qPCR is significantly (at least 3 times) more sensitive than culture in the laboratory confirmation of IMD. The study also demonstrated that culture negativity is not associated with lower bacterial loads and with less severe cases. On the other side, in patients with sepsis, qPCR can predict fatal outcome since higher bacterial load, evaluated by qPCR, appears strictly associated with most severe cases and fatal outcome. The study also showed that molecular techniques such as qPCR can provide a valuable addition to the proportion of diagnosed and serotyped cases of IMD. |
| Databáze: | OpenAIRE |
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