Limitations in the use of counterimmunoelectrophoresis (CIE) for diagnosis of Haemophilus influenzae type b meningitis
Keywords:
Haemophilus influenzae b, Counterimmunoelectrophoresis, Cross-reaction, Streptococcus pneumoniae, Bacterial meningitisAbstract
In Brazil, counterimmunoelectrophoresis (CIE) is a widely used laboratory method for bacterial meningitis diagnosis caused by Neisseria meningitidis (Men) serogroups A, B and C and Haemophilus influenzae (Hi) type b since 1970´s. With the introduction of real-time PCR (RT-PCR) assay at Instituto Adolfo Lutz routine diagnosis of meningitis caused by Men, Hi and Streptococcus pneumoniae (Spn), discrepant results between these two methodologies were found. In this work we investigated 46 cases with CIE positive results for Hib. Our main goal was to determine the ratio of Hib false positive results by CIE. For comparisons, we used RT-PCR method, latex agglutination test and culture when available. Among the 46 CIE Hib positive samples, 26 (57%) were false positive: 21 (46%) samples were Spn positives and 5 (11%) samples were negatives for Spn and Hib by both latex and RT-PCR methods. Our results show a high percentage of false positive results by CIE regarding Hib detection in CSF and sera samples. We recommend using latex agglutination or RTPCR rather than CIE for Hib determination or a second test confirmation for Hib CIE positive samples.
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Copyright (c) 2010 Lucila O. Fukasawa, Maristela M. Salgado, Maria Gisele Gonçalves, Anna Vera Custódio, Terezinha P. Araújo , Telma R. M. P. Carvalhanas, Ricardo K. M. Albernaz, Joana D'Arc P. Reis, Maria Irene Weyl A. Costa, Claudio T. Sacchi
This work is licensed under a Creative Commons Attribution 4.0 International License.
