New molecular tools for meningitis diagnostics in Ethiopia – a necessary step towards improving antimicrobial prescription
| العنوان: | New molecular tools for meningitis diagnostics in Ethiopia – a necessary step towards improving antimicrobial prescription |
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| المؤلفون: | Melkamu Berhane, Getnet Tesfaw, Alemseged Abdissa, Gemeda Abebe, Guro K. Bårnes, Dominique A. Caugant, Siri Laura Feruglio, Hannah J. Jørgensen, Esayas Kebede Gudina |
| المصدر: | BMC Infectious Diseases BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-14 (2018) |
| بيانات النشر: | Springer Science and Business Media LLC, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, FilmArray, Bacterial meningitis, Antibiotics, 0302 clinical medicine, Medical microbiology, Anti-Infective Agents, Epidemiology, Practice Patterns, Physicians', Child, Prospective cohort study, Aged, 80 and over, Middle Aged, Meningitis, Viral, Quality Improvement, Cerebrospinal fluid, Infectious Diseases, Molecular Diagnostic Techniques, Child, Preschool, Health Resources, Female, Meningitis, Research Article, Adult, medicine.medical_specialty, Adolescent, medicine.drug_class, 030231 tropical medicine, 030106 microbiology, lcsh:Infectious and parasitic diseases, Meningitis, Bacterial, Diagnosis, Differential, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Viral meningitis, Humans, lcsh:RC109-216, Hospitals, Teaching, Aged, business.industry, Infant, Newborn, Infant, Multiplex PCR, Molecular diagnostics, medicine.disease, Parasitology, Ethiopia, business, Multiplex Polymerase Chain Reaction |
| الوصف: | Background Meningitis remains a top cause of premature death and loss of disability-adjusted life years in low-income countries. In resource-limited settings, proper laboratory diagnostics are often scarce and knowledge about national and local epidemiology is limited. Misdiagnosis, incorrect treatment and overuse of antibiotics are potential consequences, especially for viral meningitis. Methods A prospective study was conducted over three months in a teaching hospital in Ethiopia with limited laboratory resources. Cerebrospinal fluid (CSF) samples from patients with suspected meningitis were analysed using a multiplex PCR-based system (FilmArray, BioFire), in addition to basic routine testing with microscopy and culture. Clinical data, as well as information on treatment and outcome were collected. Results Two hundred and eighteen patients were included; 117 (54%) neonates (0–29 days), 63 (29%) paediatrics (1 month-15 years) and 38 (17%) adults (≥16 years). Of 218 CSF samples, 21 (10%) were PCR positive; 4% in neonates, 14% in paediatrics and 18% in adults. Virus was detected in 57% of the PCR positive samples, bacteria in 33% and fungi in 10%. All CSF samples that were PCR positive for a bacterial agent had a white cell count ≥75 cells/mm3 and/or turbid appearance. The majority (90%) of patients received more than one antibiotic for treatment of the meningitis episode. There was no difference in the mean number of different antibiotics received or in the cumulative number of days with antibiotic treatment between patients with a microorganism detected in CSF and those without. Conclusions A rapid molecular diagnostic system was successfully implemented in an Ethiopian setting without previous experience of molecular diagnostics. Viral meningitis was diagnosed for the first time in routine clinical practice in Ethiopia, and viral agents were the most commonly detected microorganisms in CSF. This study illustrates the potential of rapid diagnostic tests for reducing antibiotic usage in suspected meningitis cases. However, the cost of consumables for the molecular diagnostic system used in this study limits its use in low-income countries. |
| وصف الملف: | application/pdf |
| تدمد: | 1471-2334 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8a3509e43724d0fbea4c17af474f1157Test https://doi.org/10.1186/s12879-018-3589-4Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8a3509e43724d0fbea4c17af474f1157 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712334 |
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