Molecular testing of respiratory swabs aids early recognition of meningococcal disease in children
Autor: | S.J. Mitchell, Kathryn Anne Dunlop, Michael D. Shields, Derek Fairley, Peter V. Coyle, H.J. O'Neill, Paul Jackson |
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Rok vydání: | 2011 |
Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Pathology Adolescent Genotype Mucous membrane of nose Neisseria meningitidis Meningococcal disease medicine.disease_cause Sensitivity and Specificity Gastroenterology Bacterial Proteins Predictive Value of Tests Internal medicine medicine Humans Child Genotyping Cerebrospinal Fluid Bacteriological Techniques business.industry Pharynx Infant Newborn Infant General Medicine medicine.disease Meningococcal Infections Nasal Mucosa Blood Infectious Diseases medicine.anatomical_structure Molecular Diagnostic Techniques Nasal Swab Child Preschool Relative risk Predictive value of tests Female business |
Zdroj: | Diagnostic Microbiology and Infectious Disease. 70:427-434 |
ISSN: | 0732-8893 |
Popis: | Early meningococcal disease (MD) diagnosis is difficult. We assessed rapid molecular testing of respiratory specimens. We performed genotyping of respiratory swabs, blood, and cerebrospinal fluid from children with suspected disease and nasal swabs (NSs) from matched controls. Thirty-nine of 104 suspected cases had confirmed disease. Four controls were carriers. Throat swab ctrA and porA testing for detection of disease gave a sensitivity of 81% (17/21), specificity of 100% (44/44), positive predictive value (PPV) of 100% (17/17), negative predictive value (NPV) of 92% (44/48), and relative risk of 12. NS ctrA and porA testing gave a sensitivity of 51% (20/39), specificity of 95% (62/65), PPV of 87% (20/23), NPV of 77% (62/81), and relative risk of 4. Including only the 86 NSs taken within 48 h of presentation, the results were sensitivity of 60% (18/30), specificity of 96% (54/56), PPV of 90% (18/20), NPV of 82% (54/66), and relative risk of 5. Swab type agreement was excellent (kappa 0.80, P < 0.001). There was exact phylogenetic agreement from different specimen sites for individuals. Carried genosubtypes were P1.7 and P1.21-7. Prehospital rapid molecular testing of easily obtained respiratory specimens could accelerate diagnosis of MD. |
Databáze: | OpenAIRE |
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