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Implementation of the eazyplex® CSF direct panel assay for rapid laboratory diagnosis of bacterial meningitis: 32-month experience at a tertiary care university hospital

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Abstract

We aimed to report a 32-month laboratory experience with the eazyplex® CSF direct panel assay for the rapid diagnosis of meningitis due to six most common bacterial species (Escherichia coli, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus agalactiae, and Streptococcus pneumoniae). We included all cerebrospinal fluid (CSF) samples from patients admitted with a clinical suspicion of meningitis/encephalitis between May 2016 and December 2018 at our hospital. In addition to the eazyplex® assay, both Gram stain microscopy and culture were performed, and results were confirmed with 16S rRNA PCR/sequencing. Patients’ demographics and relevant clinical information were collected. Of 135 studied patients, 44 (32.6%) had a microbiologically documented diagnosis of meningitis. Overall, we identified 21 S. pneumoniae, 10 N. meningitidis, 6 L. monocytogenes, 3 E. coli, 2 Streptococcus pyogenes, 1 S. agalactiae, and 1 Citrobacter koseri as aetiological agents. The eazyplex® assay allowed identification in 40 (90.9%) cases, with four not identified cases due to microorganisms not included in the panel at the time of testing. Thirty-two (72.7%) cases had positive culture results, whereas 28 (63.6%) cases had positive Gram stain results. Notably, combining Gram stain and eazyplex® assay allowed identification in 100% of cases. After notification of rapid results, physicians modified the empiric antibiotic therapy, which became appropriate in three patients (all with L. monocytogenes meningitis). The eazyplex® CSF panel assay worked better than culture in detecting the most common agents of bacterial meningitis and accelerated the diagnosis leading to timely initiation or continuation of appropriate antibiotic therapy.

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Acknowledgements

We wish to thank Franziska Lohmeyer for her English language assistance.

Author information

Author notes

  1. Brunella Posteraro and Teresa Spanu contributed equally to this work.

Authors and Affiliations

  1. Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Tiziana D’Inzeo, Barbara Fiori, Grazia Angela Morandotti, Maurizio Sanguinetti & Teresa Spanu

  2. Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy

    Tiziana D’Inzeo, Giulia Menchinelli, Giulia De Angelis, Barbara Fiori, Flora Marzia Liotti, Maurizio Sanguinetti, Brunella Posteraro & Teresa Spanu

  3. Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Brunella Posteraro

Authors
  1. Tiziana D’Inzeo
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  2. Giulia Menchinelli
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  3. Giulia De Angelis
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  4. Barbara Fiori
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  5. Flora Marzia Liotti
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  6. Grazia Angela Morandotti
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  7. Maurizio Sanguinetti
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  8. Brunella Posteraro
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  9. Teresa Spanu
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Corresponding author

Correspondence to Maurizio Sanguinetti.

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The authors declare that they have no conflict of interest.

Ethics approval and informed consent

The Ethics Committee of our institution approved the study (approval number 34253/17), and informed consent was waived because of testing patients’ CSF samples that were collected as part of routine clinical care.

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D’Inzeo, T., Menchinelli, G., De Angelis, G. et al. Implementation of the eazyplex® CSF direct panel assay for rapid laboratory diagnosis of bacterial meningitis: 32-month experience at a tertiary care university hospital. Eur J Clin Microbiol Infect Dis 39, 1845–1853 (2020). https://doi.org/10.1007/s10096-020-03909-5

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  • DOI: https://doi.org/10.1007/s10096-020-03909-5

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