TY - JOUR
T1 - Implementation of the eazyplex(®) CSF direct panel assay for rapid laboratory diagnosis of bacterial meningitis: 32-month experience at a tertiary care university hospital
AU - D'Inzeo, Tiziana
AU - Menchinelli, Giulia
AU - De Angelis, Giulia
AU - Fiori, Barbara
AU - Liotti, Flora Marzia
AU - Morandotti, Grazia Angela
AU - Sanguinetti, Maurizio
AU - Posteraro, Brunella
AU - Spanu Pennestri, Teresa
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - MENINGITIS
KW - MENINGITIS
UR - http://hdl.handle.net/10807/154684
U2 - 10.1007/s10096-020-03909-5
DO - 10.1007/s10096-020-03909-5
M3 - Article
SN - 0934-9723
VL - 2020
SP - 1
EP - 9
JO - European Journal of Clinical Microbiology and Infectious Diseases
JF - European Journal of Clinical Microbiology and Infectious Diseases
ER -