用于快速检测儿童脑脊液样本中细菌性脑膜炎病原体的线性探针检测法的评估
Evaluation of the line probe assay for the rapid detection of bacterial meningitis pathogens in cerebrospinal fluid samples from children.
作者信息
Soysal Ahmet, Toprak Demet Gedikbasi, Türkoğlu Salih, Bakir Mustafa
机构信息
Division of Pediatric Infectious Diseases, Marmara University Medical Faculty Department of Pediatrics, Istanbul, Turkey.
Division of Pediatric Infectious Diseases, Marmara University Pendik Training and Research Hospital Department of Pediatrics, Mimar Sinan Street, No:41, Fevzi Cakmak Mah. Ust Kaynarca, Pendik, Istanbul, Turkey.
出版信息
BMC Microbiol. 2017 Jan 11;17(1):14. doi: 10.1186/s12866-016-0834-0.
BACKGROUND
The aim of this study is to compare the diagnostic performance of the line probe assay (LPA) with conventional multiplex polymerase chain reaction (PCR) for Streptococcus pneumoniae as well as real-time PCR for Neisseria meningitidis and Haemophilus influenzae type b (Hib) in cerebrospinal fluid (CSF) samples from children during the multicenter national surveillance of bacterial meningitis between the years 2006 and 2009 in Turkey.
RESULTS
During the study period 1460 subjects were enrolled and among them 841 (57%) met the criteria for probable bacterial meningitis. The mean age of subjects was 51 ± 47 months (range, 1-212 months). We performed the line probe assay in 751 (89%) CSF samples of 841 probable bacterial meningitis cases, of whom 431 (57%) were negative, 127 (17%) were positive for S. pneumoniae, 53 (7%) were positive for H. influenzae type b, and 41 (5%) were positive for N. meningitidis. The LPA was positive in 19 of 23 (82%) S. pneumoniae samples, 4 of 6 (67%) N. meningitidis samples and 2 of 2 (100%) Hib samples in CSF culture-positive cases. The specificity of the LPA for all of S. pneumoniae, H. influenzae type b, and N. meningitidis was 88% (95% CI: 85-91%), when using the standard PCR as a reference. The specificity of LPA for each of S. pneumoniae, H. influenzae type b, and N. meningitidis was 93% (95% CI: 89-95%), 96% (95% CI: 94-98%), and 99% (95% CI: 97-99%), respectively. For all of S. pneumoniae, H. influenzae type b and N. meningitidis the sensitivity of the LPA was 76% (95% CI: 70-82%) and for each of S. pneumoniae, H. influenzae type b and N. meningitidis was 72% (95% CI:63-79%), 88% (95% CI: 73-95%), and 81% (95% CI:67-92%), respectively.
CONCLUSIONS
The LPA assay can be used to detect common bacterial meningitis pathogens in CSF samples, but the assay requires further improvement.
背景
本研究旨在比较线性探针分析（LPA）与传统多重聚合酶链反应（PCR）对肺炎链球菌的诊断性能，以及实时PCR对脑膜炎奈瑟菌和b型流感嗜血杆菌（Hib）在2006年至2009年土耳其全国细菌性脑膜炎多中心监测期间儿童脑脊液（CSF）样本中的诊断性能。
结果
在研究期间，共纳入1460名受试者，其中841名（57%）符合可能的细菌性脑膜炎标准。受试者的平均年龄为51±47个月（范围为1 - 212个月）。我们对841例可能的细菌性脑膜炎病例中的751份（89%）脑脊液样本进行了线性探针分析，其中431份（57%）为阴性，127份（17%）肺炎链球菌阳性，53份（7%）b型流感嗜血杆菌阳性，41份（5%）脑膜炎奈瑟菌阳性。在脑脊液培养阳性的病例中，LPA在23份肺炎链球菌样本中的19份（82%）、6份脑膜炎奈瑟菌样本中的4份（67%）和2份Hib样本中的2份（100%）呈阳性。以标准PCR为参考时，LPA对所有肺炎链球菌、b型流感嗜血杆菌和脑膜炎奈瑟菌的特异性为88%（95%CI：85 - 91%）。LPA对肺炎链球菌、b型流感嗜血杆菌和脑膜炎奈瑟菌各自的特异性分别为93%（95%CI：89 - 95%）、96%（95%CI：94 - 98%）和99%（95%CI：97 - 99%）。对于所有肺炎链球菌、b型流感嗜血杆菌和脑膜炎奈瑟菌，LPA的敏感性为76%（95%CI：70 - 82%），对于肺炎链球菌、b型流感嗜血杆菌和脑膜炎奈瑟菌各自的敏感性分别为72%（95%CI：63 - 79%）、88%（95%CI：73 - 95%）和81%（95%CI：67 - 92%）。
结论
LPA分析可用于检测脑脊液样本中常见的细菌性脑膜炎病原体，但该分析方法需要进一步改进。
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