TY - JOUR
T1 - Optimization of the Diagnosis of Central Nervous System Infections in Vietnamese Hospitals
T2 - Results From a Retrospective Multicenter Study
AU - Dong, Do Van
AU - Boutin, Sébastien
AU - Sang, Vu Viet
AU - Manh, Nguyen Dang
AU - Hoan, Nghiem Xuan
AU - Quang, Hoang Xuan
AU - Lien, Tran Thi
AU - Trang, Van Dinh
AU - The, Nguyen Trong
AU - Linh, Le Thi Kieu
AU - Schmauder, Kristina
AU - Ueltzhöffer, Viola
AU - Hafza, Nourhane
AU - Hauswaldt, Susanne
AU - Rupp, Jan
AU - Kremsner, Peter G
AU - Song, Le Huu
AU - Nurjadi, Dennis
AU - Peter, Silke
AU - Velavan, Thirumalaisamy P
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2024/9
Y1 - 2024/9
N2 - INTRODUCTION: Central nervous system infections pose significant health challenges, particularly in low- and middle-income countries, because of high morbidity and mortality rates. Rapid and accurate diagnosis is essential for effective treatment to prevent adverse outcomes. Traditional culture-based diagnostics are often slow and lack specificity. This study evaluates the BioFire FilmArray Meningitis/Encephalitis (FAME) Panel against standard diagnostics in Vietnam to assess its clinical impact and suitability for local epidemiology.METHODS: We conducted a prospective study involving 330 patients with suspected central nervous system infections at 4 hospitals in northern Vietnam from July 2022 to April 2023. Cerebrospinal fluid samples were analyzed using routine culture methods and FAME. We compared pathogen detection rates and assessed the potential clinical impact of FAME results on patient management.RESULTS: Of the 330 cerebrospinal fluid specimens, 64 (19%) were positive by either conventional diagnostics (n = 48) and/or FAME (n = 33). The agreement between FAME and conventional diagnostics was 87%. Key pathogens
Mycobacterium tuberculosis (n = 7),
Klebsiella pneumoniae (n = 5),
Streptococcus suis (n = 5), Epstein-Barr virus (n = 3),
Acinetobacter baumannii (n = 1), and
Trichosporon asahii (n = 1) were not detected by FAME. Classical meningitis parameter clinical symptoms, altered glucose, protein, and pleocytosis were good predictors of FAME positivity, indicating their utility in optimizing local diagnostic algorithms.
CONCLUSIONS: FAME complements traditional diagnostics by offering rapid and broad pathogen detection, crucial for timely and appropriate therapy. However, its effectiveness varies with local epidemiology, and it should not replace conventional methods entirely. Tailoring diagnostic panels to regional pathogen prevalence is recommended to enhance diagnostic accuracy and clinical outcomes in low- and middle-income countries.
AB - INTRODUCTION: Central nervous system infections pose significant health challenges, particularly in low- and middle-income countries, because of high morbidity and mortality rates. Rapid and accurate diagnosis is essential for effective treatment to prevent adverse outcomes. Traditional culture-based diagnostics are often slow and lack specificity. This study evaluates the BioFire FilmArray Meningitis/Encephalitis (FAME) Panel against standard diagnostics in Vietnam to assess its clinical impact and suitability for local epidemiology.METHODS: We conducted a prospective study involving 330 patients with suspected central nervous system infections at 4 hospitals in northern Vietnam from July 2022 to April 2023. Cerebrospinal fluid samples were analyzed using routine culture methods and FAME. We compared pathogen detection rates and assessed the potential clinical impact of FAME results on patient management.RESULTS: Of the 330 cerebrospinal fluid specimens, 64 (19%) were positive by either conventional diagnostics (n = 48) and/or FAME (n = 33). The agreement between FAME and conventional diagnostics was 87%. Key pathogens
Mycobacterium tuberculosis (n = 7),
Klebsiella pneumoniae (n = 5),
Streptococcus suis (n = 5), Epstein-Barr virus (n = 3),
Acinetobacter baumannii (n = 1), and
Trichosporon asahii (n = 1) were not detected by FAME. Classical meningitis parameter clinical symptoms, altered glucose, protein, and pleocytosis were good predictors of FAME positivity, indicating their utility in optimizing local diagnostic algorithms.
CONCLUSIONS: FAME complements traditional diagnostics by offering rapid and broad pathogen detection, crucial for timely and appropriate therapy. However, its effectiveness varies with local epidemiology, and it should not replace conventional methods entirely. Tailoring diagnostic panels to regional pathogen prevalence is recommended to enhance diagnostic accuracy and clinical outcomes in low- and middle-income countries.
U2 - 10.1093/ofid/ofae531
DO - 10.1093/ofid/ofae531
M3 - Journal articles
C2 - 39346707
SN - 2328-8957
VL - 11
SP - ofae531
JO - Open forum infectious diseases
JF - Open forum infectious diseases
IS - 9
ER -