Diagnostic accuracy of VIDISCA-NGS in patients with suspected central nervous system infections.
Clin Microbiol Infect
; 27(4): 631.e7-631.e12, 2021 Apr.
Article
de En
| MEDLINE
| ID: mdl-32590059
ABSTRACT
OBJECTIVES:
Confirming the diagnosis in viral central nervous system (CNS) infections can be difficult with the currently available diagnostic tools. Virus discovery cDNA-amplified fragment length polymorphism next-generation sequencing (VIDISCA-NGS) is a promising viral metagenomic technique that enables the detection of all viruses in a single assay. We performed a retrospective study on the diagnostic accuracy of VIDISCA-NGS in cerebrospinal fluid (CSF) of individuals with suspected CNS infections.METHODS:
Consecutive adult patients presenting to the Emergency Department or inpatients, who underwent a lumbar puncture for the suspicion of a CNS infection, were included if they were diagnosed with a viral CNS infection, or if a viral CNS infection was initially suspected but eventually a different diagnosis was made. A quantitative PCR panel of the most common causative viruses was performed on CSF of these patients as reference standard and compared with the results of VIDISCA-NGS, the index test.RESULTS:
We included 38 individuals with viral CNS infections and 35 presenting with suspected CNS infection for whom an alternative aetiology was finally established. Overall sensitivity and specificity were 52% (95% CI 31%-73%) and 100% (95% CI 91%-100%), respectively. One enterovirus, detected by VIDISCA-NGS, was only identified by quantitative PCR upon retesting. Additional viruses identified by VIDISCA-NGS consisted of GB virus C, human papillomavirus, human mastadenovirus C, Merkel cell polyoma virus and anelloviruses.CONCLUSION:
In patients for whom routine diagnostics do not yield a causative pathogen, VIDISCA-NGS can be of additional value as it can detect a broader range of viruses, but it does not perform well enough to replace quantitativePCR.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Virus
/
Maladies virales
/
Infections du système nerveux central
/
Analyse de polymorphisme de longueur de fragments amplifiés
/
Séquençage nucléotidique à haut débit
Type d'étude:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Clin Microbiol Infect
Sujet du journal:
DOENCAS TRANSMISSIVEIS
/
MICROBIOLOGIA
Année:
2021
Type de document:
Article
Pays d'affiliation:
Pays-Bas