Unexpectedly High False-Positive Rates for Haemophilus influenzae Using a Meningoencephalitis Syndromic PCR Panel in Two Tertiary Centers

Article Article scientifique Article Unexpectedly High False-Positive Rates for Haemophilus influenzae Using a Meningoencephalitis Syndromic PCR Panel in Two Tertiary Centers eng 2021 author Zanella Marie-Céline 538298 author Cherkaoui Abdessalam 504646 author Hinic Vladimira 677087 author Renzi Gesuele 111073 author Goldenberger Daniel author Egli Adrian author Schrenzel Jacques 29184 639658 10.3389/fcimb.2021.639658 33763388 2235-2988 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982903/pdf/fcimb-11-639658.pdf False-positive results in the diagnostic of meningitis and encephalitis pose important challenges. This study aimed to determine false-positive rates for Haemophilus influenzae in cerebrospinal fluids evaluated by the BioFire FilmArray® Meningitis/Encephalitis Panel. We conducted a retrospective study of all H. influenzae-positive FilmArray®. Meningitis/Encephalitis Panel results from June 2016 to October 2019 in two Swiss university hospitals. Cases were classified as true positive, likely true-positive, and likely false-positive results according to cerebrospinal fluid culture, H. influenzae-specific quantitative real-time PCR (qPCR), and Gram staining, as well as culture of other materials. We performed 3,082 panels corresponding to 2,895 patients: 0.6% of the samples (18/3,082) were positive for H. influenzae. Culture and H. influenzae-specific qPCR were performed on 17/18 (94.4%) and 3/18 (16.7%) cerebrospinal fluid samples, respectively; qPCR was negative in all cases. Among 17 samples sent for culture, 10 concerned patients were not treated with antibiotics prior to lumbar puncture. Only 1/17 revealed growth of H. influenzae and was classified as a true positive. We further classified 3/18 (16.7%) cases with the identification of Gram-negative rods in the cerebrospinal fluid or positive blood cultures for H. influenzae as likely true-positive and 14/18 (77.8%) cases as likely false-positive. Diagnostic results should always be interpreted together with the clinical presentation, cerebrospinal fluid analysis, and other available microbiological results. All H. influenzae-positive results should be viewed with special caution and a H. influenzae-specific qPCR should be systematically considered. Diagnostic Tests Routine Haemophilus influenzae Humans Meningitis Meningoencephalitis Retrospective Studies Dewey 616 56 Département de médecine 221 false 338 Génomique et microbiote 604 Frontiers in Cellular and Infection Microbiology 11 7de510e5-0fd7-4e74-8994-2d93a2d76efb Article (Published version) Public fcimb-11-639658.pdf 366637 application/pdf CC BY a6425435-843e-4bee-a8d6-001a059b3edf Supplemental data Public Table_1.docx 678980 application/vnd.openxmlformats-officedocument.wordprocessingml.document openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Unexpectedly High False-Positive Rates for Haemophilus influenzae Using a Meningoencephalitis Syndromic PCR Panel in Two Tertiary Centers	Frontiers in Cellular and Infection Microbiology			2021	190	247

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Hinic, Vladimira