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Incorporation of real-time PCR into routine Public Health Surveillance of Culture Negative Bacterial meningitis in São paulo, Brazil

Sacchi, CT and Fukasawa, LO and Gonçalves, MG and Salgado, MM and Shutt, KA and Carvalhanas, TR and Ribeiro, AF and Kemp, B and Gorla, MCO and Albernaz, RK and Marques, EGL and Cruciano, A and Waldman, EA and Brandileone, MCC and Harrison, LH and São Paulo RT-PCR Surveillance Project Team, (2011) Incorporation of real-time PCR into routine Public Health Surveillance of Culture Negative Bacterial meningitis in São paulo, Brazil. PLoS ONE, 6 (6).

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Abstract

Real-time (RT)-PCR increases diagnostic yield for bacterial meningitis and is ideal for incorporation into routine surveillance in a developing country. We validated a multiplex RT-PCR assay for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae in Brazil. Risk factors for being culture-negative, RT-PCR positive were determined. The sensitivity of RT-PCR in cerebrospinal fluid (CSF) was 100% (95% confidence limits, 96.0%-100%) for N. meningitidis, 97.8% (85.5%-99.9%) for S. pneumoniae, and 66.7% (9.4%-99.2%) for H. influenzae. Specificity ranged from 98.9% to 100%. Addition of RT-PCR to routine microbiologic methods increased the yield for detection of S. pneumoniae, N. meningitidis, and H. influenzae cases by 52%, 85%, and 20%, respectively. The main risk factor for being culture negative and RT-PCR positive was presence of antibiotic in CSF (odds ratio 12.2, 95% CI 5.9-25.0). RT-PCR using CSF was highly sensitive and specific and substantially added to measures of meningitis disease burden when incorporated into routine public health surveillance in Brazil. © 2011 Sacchi et al.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sacchi, CT
Fukasawa, LO
Gonçalves, MG
Salgado, MM
Shutt, KAshuttk@pitt.eduSHUTTK
Carvalhanas, TR
Ribeiro, AF
Kemp, B
Gorla, MCO
Albernaz, RK
Marques, EGL
Cruciano, A
Waldman, EA
Brandileone, MCC
Harrison, LHlharriso@edc.pitt.eduLHARRISO
São Paulo RT-PCR Surveillance Project Team,
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
InvestigatorCustódio, Anna VeraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorAraújo, Terezinha PUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorZanella, Rosemeire CoboUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Investigatorde Lemos, Ana Paula SilvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorGuerra, Maria Luiza L SUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorZanelato, Conceição Martins da CostaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorGalhardo, MartaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorMalheiro, VeraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorNakazaki, Rosa M DUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorFernandes, RachelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorRamos, Sonia R T da SilvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorGuarnieri, Célia EUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Investigatorde Souza, Simone AUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorMaki, MarceloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorValdetaro, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorRujula, Maria J PUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorVicentine, Elza L UUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorRosenfeld, SueliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorMagalhães, ElaineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorRossi, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorNogueira, Marilia VUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorOsiro, KatsumiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorFrigatto, A MUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorJyh, Juang HUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorLoda, Regina MUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorAmorin, Walter B GUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Investigatorde Araújo, Marcia CUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorModesto, RossiniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorSincok, Veronica MUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorLevy, Carlos EUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorRussi, Elizabete AUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorBadur, Nereide A BUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorCocolisce, Ricardo AUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
InvestigatorKuboyama, Rogério AUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
EditorLin, BaochuanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 27 June 2011
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 6
Number: 6
DOI or Unique Handle: 10.1371/journal.pone.0020675
Schools and Programs: Graduate School of Public Health > Epidemiology
Graduate School of Public Health > Infectious Diseases and Microbiology
Refereed: Yes
MeSH Headings: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Typing Techniques; Brazil; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Leukocyte Count; Male; Meningitis, Bacterial--blood; Meningitis, Bacterial--cerebrospinal fluid; Meningitis, Bacterial--microbiology; Middle Aged; Multivariate Analysis; Neisseria meningitidis--classification; Neisseria meningitidis--genetics; Population Surveillance--methods; Reproducibility of Results; Reverse Transcriptase Polymerase Chain Reaction--methods; Risk Factors; Sensitivity and Specificity; Young Adult
Other ID: NLM PMC3120771
PubMed Central ID: PMC3120771
PubMed ID: 21731621
Date Deposited: 05 Sep 2012 17:40
Last Modified: 02 Aug 2020 12:56
URI: http://d-scholarship.pitt.edu/id/eprint/13872

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