TY  - JOUR
ID  - pittir13872
UR  - http://d-scholarship-dev.library.pitt.edu/13872/
IS  - 6
A1  - Sacchi, CT
A1  - Fukasawa, LO
A1  - Gonçalves, MG
A1  - Salgado, MM
A1  - Shutt, KA
A1  - Carvalhanas, TR
A1  - Ribeiro, AF
A1  - Kemp, B
A1  - Gorla, MCO
A1  - Albernaz, RK
A1  - Marques, EGL
A1  - Cruciano, A
A1  - Waldman, EA
A1  - Brandileone, MCC
A1  - Harrison, LH
A1  - São Paulo RT-PCR Surveillance Project Team, 
Y1  - 2011/06/27/
N2  - Real-time (RT)-PCR increases diagnostic yield for bacterial meningitis and is ideal for incorporation into routine surveillance in a developing country. We validated a multiplex RT-PCR assay for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae in Brazil. Risk factors for being culture-negative, RT-PCR positive were determined. The sensitivity of RT-PCR in cerebrospinal fluid (CSF) was 100% (95% confidence limits, 96.0%-100%) for N. meningitidis, 97.8% (85.5%-99.9%) for S. pneumoniae, and 66.7% (9.4%-99.2%) for H. influenzae. Specificity ranged from 98.9% to 100%. Addition of RT-PCR to routine microbiologic methods increased the yield for detection of S. pneumoniae, N. meningitidis, and H. influenzae cases by 52%, 85%, and 20%, respectively. The main risk factor for being culture negative and RT-PCR positive was presence of antibiotic in CSF (odds ratio 12.2, 95% CI 5.9-25.0). RT-PCR using CSF was highly sensitive and specific and substantially added to measures of meningitis disease burden when incorporated into routine public health surveillance in Brazil. © 2011 Sacchi et al.
JF  - PLoS ONE
VL  - 6
TI  - Incorporation of real-time PCR into routine Public Health Surveillance of Culture Negative Bacterial meningitis in São paulo, Brazil
AV  - public
ER  -