Abstract
Background: Automated molecular panels are attractive tools for improving early meningitis diagnosis. This study assessed the Eazyplex® CSF direct M panel (EP), a multiplex real-time Loop-Mediated Isothermal Amplification assay. Methods: From December 2016 to December 2019, cerebrospinal fluid (CSF) samples were routinely tested with the EP V1.0. CSF parameters and microbiological and clinical data were retrospectively collected. Results: Out of 230 CSF samples, the EP yielded positive, negative, and invalid results for 32 (13.9%) (16 N. meningitidis, nine S. pneumoniae, two S. agalactiae, two E. coli, two H. influenzae, one L. monocytogenes), 182 (79.1%), and 16 (7%) samples, respectively. Among the positive samples, 14 (44%) remained negative in culture (antibiotic therapy before lumbar puncture (n = 11), meningococcal meningitis (n = 3)). High CSF protein concentrations and cellularity were associated with LAMP inhibition, counteracted by centrifugation. The automated software yielded 13 false positive and five false negative results. Amplification curve analysis was necessary and enabled the attainment of positive (PPA) and negative percentage agreement and positive and negative predictive values of 91.4%, 100%, 100%, and 98.3%. Three false negative results remained (two E. coli and one N. meningitidis). E. coli presented the poorest PPA (50%). Conclusion: This work confirms the strong performance of the EP, of particular interest in cases of antibiotic therapy before lumbar puncture.
Highlights
The prognosis of bacterial meningitis remains strongly correlated to the timing of adequate antibiotic treatment initiation [1,2]
We retrospectively identified patients with suspected meningitis whose cerebrospinal fluid (CSF) samples were tested with the Eazyplex® CSF direct M panel (AmplexDiagnostics GmbH, Gars-Bahnhof, Germany), at the physician’s and/or microbiologist’s discretion, from
7505 CSF specimens were analyzed, of which 236 samples from 225 patients were subjected to Eazyplex® panel (EP) testing
Summary
The prognosis of bacterial meningitis remains strongly correlated to the timing of adequate antibiotic treatment initiation [1,2]. French and European guidelines recommend the use of molecular methods (i) whenever possible when bacterial meningitis is strongly suspected and the direct examination is negative, and (ii) when. Microorganisms 2021, 9, 1859 the direct examination is positive and the culture remains negative at 24 h [3,4]. Few molecular multiplex panels have been developed for the diagnosis of bacterial meningitis. The Eazyplex® CSF direct M panel (AmplexDiagnostics GmbH, Gars-Bahnhof, Germany) can detect the six most common meningeal pathogens thanks to a multiplex real-time Loop-Mediated Isothermal Amplification (LAMP) approach. 14 (44%) remained negative in culture (antibiotic therapy before lumbar puncture (n = 11), meningococcal meningitis (n = 3)). High CSF protein concentrations and cellularity were associated with LAMP inhibition, counteracted by centrifugation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
