Validation of the counterimmunoelectrophoresis assay for laboratory diagnosis of meningit
Keywords:
Counterimmunoelectrophoresis, Validation, Laboratory Diagnosis, Bacterial Meningitidis., Neisseria meningitidisAbstract
Counterimmunoelectrophoresis (CIE) is widely used in Brazil for non-culture diagnosis of meningitis caused by Neisseria meningitidis (Men) of serogroups A, B, C, W135 or Haemophilus influenzae serotype b (Hib). The objective of this study was to validate CIE using 301 samples of cerebrospinal fluid (CSF) and serum samples from 236 patients with suspected bacterial th meningitis in the cities of São Paulo and Campinas during the period comprised between June 4 , th 2007 to May 30 , 2009. In CSF specimens, CIE had a sensitivity of 62.7% (42/67) (95% CI, 50%- 74.2%) and specificity of 88.9% (208/234) (95% CI, 84.1% -92.6%) for the detection of Men. In serum, the sensitivity was 35.3% (6/17) (95% CI 14.2% -61.7%) and specificity 90.9% (199/219) (95% CI, 86.3% -94.4%). These parameters were not calculated for the Hib component, due to the unavailability of a significant number of samples with positive culture for this bacterium. Our results showed that the CIE assay although having relatively high specificity, showed low sensitivity, especially in serum samples, indicating that CIE is not recommended as the only diagnostic test for bacterial meningitis. Additionally, it reflects the need of the use of other non[1]culture tests with high sensitivity and specificity, such as real-time PCR to improve both clinical and the public health surveillance system.
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Greenwood BM, Whittle HC, Dominic Rajkovic O. Counter-current immunoelectrophoresis in the diagnosis of meningococcal infections. Lancet. 1971;2(7723):519-21.
Edwards EA. Immunological investigations of meningococcal disease. I. Group-specific Neisseria meningitidis antigens presented in the serum of patients with fulminant meningococcemia. J Immunol. 1971;106(2):314-7.
Coonrod JD, Rytel MW. Determination of aetiology of bacterial meningitis by counter immunoelectrophoresis. Lancet. 1972;1(7761):1154-7.
Hoffman TA, Edwards EA. Group-specific polysaccharide antigen and humoral antibody response in disease due to Neisseria meningitidis. J Infect Dis. 1972;126(6):636-44.
Palhares M, Gelli DS, Almeida MCR, Mellis CEA, Takeda AK, Taunay AE. Pesquisa de polissacarídeos de Neisseria meningitidis do grupo C no líquido cefalorraquidiano por imunoeletroforese cruzada em acetato de celulose. Rev Inst Adolfo Lutz. 1973;33:85-9.
Requejo HIZ. A meningite meningocócica no mundo. São Paulo: Edições Inteligentes; 2004.
Fonseca C, Moraes JC, Barata RB. O livro da meningite, uma doença sob a luz da cidade. São Paulo: Segmento Farma; 2004.
Instituto Adolfo Lutz, Seção de Imunologia, Laboratório de Meningites Bacterianas. Introdução da PCR convencional e em tempo real para o diagnóstico laboratorial das meningites bacterianas no Instituto Adolfo Lutz. BEPA. Bol. Epidemiol. Paul. 2007;4(40):24-7.
Sacchi CT, Fukasawa LO, Gonçalves MG, Salgado MM, Shutt KA, Carvalhanas TR, et al. Incorporation of real-time PCR into routine public health surveillance of culture negative bacterial meningitis in São Paulo, Brazil. PLos One. 2011;6(6):1-8.
Requejo HI, Nascimento CM, Fahrat CK. Comparison of counterimmunoelectrophoresis, latex agglutination and bacterial culture f or the diagnosis of bacterial meningitis using urine, serum and cerebrospinal fluid samples. Braz J Med Biol Res. 1992;25(4):357-67.
Alkmin MGA, Landgraf IM, Vieira MFP, Camargo MCC, Gonçalves MIC. Diagnosis of bacterial meningitis and septicemia by serum counterimmunoelectrophoresis. Braz J Med Biol Res. 1995;28:1065-8.
Pires LA, Reis Filho JB. Contraimunoeletroforese no diagnóstico etiológico das meningitis bacterianas. HU Rev. 1990;17(2):145-67.
Tilton RC, Dias F, Ryan RW. Comparative evaluation of three commercial products and counterimmunoelectrophoresis for the detection of antigens in cerebrospinal fluid. J Clin Microbiol. 1984;20(2):231-4. Validação da técnica de contraimunoeletroforese (CIE) para o diagnóstico laboratorial das meningites causadas por Neisseria meningitidis sorogrupos A, B, C e W135/Fukasawa LO et al. página 20 BEPA 2012;9(102):13-20
Colding H, Lind I. Counterimmunoeletrophoresis in the diagnosis of bacterial meningitis. J Clin Microbiol. 1977;5(4):405-9.
Hoban DJ, Witwicki E, Hammond GW. Bacterial antigen detection in cerebrospinal fluid of patients with meningitis. Diagn Microbiol Infect Dis. 1985;3(5):373-9.
Fukasawa LO, Salgado MM, Gonçalves MG, Custódio AV, Araújo TP, Carvalhanas TRMP, et al. Limitações no uso da técnica de contraimunoeletroforese (CIE) para o diagnóstico das meningites causadas por Haemophilus influenzaetipo b. BEPA. Bol. Epidemiol. Paul. 2010;7(76):4-12. Correspondência/Correspondence to: Lucila Okuyama Fukasawa Av. Dr. Arnaldo, 355, 11° andar CEP: 01246-902 – São Paulo/SP– Brasil Tel.: 55 11 3068-2899 E-mail: lucilaof@gmail.com Recebido em: 17/08/2011 Aprovado em: 25/06/201
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Copyright (c) 2012 Lucila Okuyama Fukasawa, Maristela Marques Salgado, Eneida G. Lemes Marques, Rachel M.B.P. Fernandes, Brigina Kemp, Telma Regina Carvalhanas , Lee H. Harrison, Cláudio Tavares Sacchi, Grupo de Trabalho das Mening
This work is licensed under a Creative Commons Attribution 4.0 International License.
