Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections

No agent is implicated in most central nervous system (CNS) infections. To investigate cerebrospinal fluid samples from patients with CNS infections of unknown cause in 1 hospital in Taiwan, we used a staged molecular approach, incorporating techniques including multiplex MassTag PCR, 16S rRNA PCR,...

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Bibliographic Details
Main Authors: Chien-Chin Hsu, Rafal Tokarz, Thomas Briese, Hung-Chin Tsai, Phenix-Lan Quan, W. Ian Lipkin
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2013-09-01
Series:Emerging Infectious Diseases
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Online Access:https://wwwnc.cdc.gov/eid/article/19/9/13-0474_article
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Summary:No agent is implicated in most central nervous system (CNS) infections. To investigate cerebrospinal fluid samples from patients with CNS infections of unknown cause in 1 hospital in Taiwan, we used a staged molecular approach, incorporating techniques including multiplex MassTag PCR, 16S rRNA PCR, DNA microarray, and high-throughput pyrosequencing. We determined the infectious agent for 31 (24%) of 131 previously negative samples. Candidate pathogens were identified for 25 (27%) of 94 unexplained meningitis cases and 6 (16%) of 37 unexplained encephalitis cases. Epstein-Barr virus (18 infections) accounted for most of the identified agents in unexplained meningitis cases, followed by Escherichia coli (5), enterovirus (2), human herpesvirus 2 (1), and Mycobacterium tuberculosis. Herpesviruses were identified in samples from patients with unexplained encephalitis cases, including varicella-zoster virus (3 infections), human herpesvirus 1 (2), and cytomegalovirus (1). Our study confirms the power of multiplex MassTag PCR as a rapid diagnostic tool for identifying pathogens causing unexplained CNS infections.
ISSN:1080-6040
1080-6059