Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay.
Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay.
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DOI：
10.3389/fneur.2020.602267
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发表时间：
2020
影响因子：
3.4
通讯作者：
Alharbi NK
中科院分区：
文献类型：
--
作者：
Aldriweesh MA;Shafaay EA;Alwatban SM;Alkethami OM;Aljuraisi FN;Bosaeed M;Alharbi NK
背景：中枢神经系统（CNS）感染与高发病率和死亡率相关，尽管分子检测取得了进展，但无菌性脑膜炎的诊断仍然具有挑战性。无菌性脑膜炎病例在世界范围内经常被低估，这影响了患者护理的质量。因此，我们旨在评估BioFire®FilmArray®脑膜炎/脑炎（ME） PCR检测结果、无菌性脑膜炎患者的临床特征和病因。方法：回顾性分析2018年1月至2020年1月在一家大型三级医疗中心接受腰椎穿刺和脑脊液（CSF）检测并符合无菌性脑膜炎定义的所有儿童和成人患者。结果：回顾了1607例患者的数据；240例符合纳入标准，其中男性占54.6%,<4岁者占68.8%。无菌性脑膜炎病毒性病因检出率为40.4%；因此，仍有59.6%的患者病因不明。在已发现的病毒性脑膜炎中，肠病毒和人疱疹病毒6型（HHV-6）最为常见（分别为25%和7.9%）。中位住院时间为6天，不明原因无菌性脑膜炎患者的住院时间更长（p < 0.0001）。结论：无菌性脑膜炎在疑似脑膜炎患者中较为常见，但多数病例病因不明。最常见的病毒是肠道病毒，其次是HHV-6，在男性和儿科年龄组中占优势。这些结果表明，在目前的诊断方法中，需要进一步研究以确定无菌性脑膜炎的其他病因和可能的其他病毒性病原体。
Background: Central nervous system (CNS) infection is associated with high rates of morbidity and mortality, and despite advancements in molecular testing, aseptic meningitis remains challenging to diagnose. Aseptic meningitis cases are often underreported worldwide, which impacts the quality of patient care. Therefore, we aimed to assess the results of BioFire® FilmArray® meningitis/encephalitis (ME) PCR panel, clinical characteristics, and etiologies of aseptic meningitis patients. Methods: From January 2018 to January 2020, all pediatric and adult patients in a large tertiary medical center who underwent lumbar puncture and cerebrospinal fluid (CSF) testing by a ME multiplex PCR panel and who fit the aseptic meningitis definition were retrospectively reviewed. Results: Data were reviewed from 1,607 patients; 240 met the inclusion criteria (54.6% males; 68.8% <4 years of age). The rate of detected viral causes of aseptic meningitis was 40.4%; therefore, 59.6% of the patients remained with unidentified etiology. Among the identified viral meningitis, enterovirus and human herpesvirus 6 (HHV-6) were the most common (25 and 7.9%, respectively). The median length of hospital stay was 6 days, and it was longer in patients with unidentifiable aseptic meningitis (p < 0.0001). Conclusion: Aseptic meningitis is common among suspected meningitis patients, but most cases remained of unknown etiology. The most common identified viruses were enterovirus followed by HHV-6, and there is predominance in males and the pediatric age group. These results highlight that further research is needed to identify other etiologies and possible additional viral pathogens for aseptic meningitis in the current diagnostic methods.
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影响因子：
1.6
作者：
Jarrin I;Sellier P;Lopes A;Morgand M;Makovec T;Delcey V;Champion K;Simoneau G;Green A;Mouly S;Bergmann JF;Lloret-Linares C
通讯作者：
Lloret-Linares C
影响因子：
168.9
作者：
McIntyre, Peter B.;O'Brien, Katherine L.;van de Beek, Diederik
通讯作者：
van de Beek, Diederik
影响因子：
28.2
作者：
Kadambari, Seilesh;Okike, Ifeanyichukwu;Ladhani, Shamez N.
通讯作者：
Ladhani, Shamez N.
影响因子：
8.4
作者：
Dash, Nihar;Ameen, Abdulmajeed S.;Smego, Raymond A., Jr.
通讯作者：
Smego, Raymond A., Jr.
影响因子：
3.6
作者：
Hasbun, Rodrigo;Wootton, Susan H.;Ginocchio, Christine C.
通讯作者：
Ginocchio, Christine C.