title: Evaluation of the line probe assay for the rapid detection of bacterial meningitis pathogens in cerebrospinal fluid samples from children.
abstract: The aim of this study is to compare the diagnostic performance of the line probe assay (LPA) with conventional multiplex polymerase chain reaction (PCR) for Streptococcus pneumoniae as well as real-time PCR for Neisseria meningitidis and Haemophilus influenzae type b (Hib) in cerebrospinal fluid (CSF) samples from children during the multicenter national surveillance of bacterial meningitis between the years 2006 and 2009 in Turkey.
  
  
  
  During the study period 1460 subjects were enrolled and among them 841 (57%) met the criteria for probable bacterial meningitis. The mean age of subjects was 51 ± 47 months (range, 1-212 months). We performed the line probe assay in 751 (89%) CSF samples of 841 probable bacterial meningitis cases, of whom 431 (57%) were negative, 127 (17%) were positive for S. pneumoniae, 53 (7%) were positive for H. influenzae type b, and 41 (5%) were positive for N. meningitidis. The LPA was positive in 19 of 23 (82%) S. pneumoniae samples, 4 of 6 (67%) N. meningitidis samples and 2 of 2 (100%) Hib samples in CSF culture-positive cases. The specificity of the LPA for all of S. pneumoniae, H. influenzae type b, and N. meningitidis was 88% (95% CI: 85-91%), when using the standard PCR as a reference. The specificity of LPA for each of S. pneumoniae, H. influenzae type b, and N. meningitidis was 93% (95% CI: 89-95%), 96% (95% CI: 94-98%), and 99% (95% CI: 97-99%), respectively. For all of S. pneumoniae, H. influenzae type b and N. meningitidis the sensitivity of the LPA was 76% (95% CI: 70-82%) and for each of S. pneumoniae, H. influenzae type b and N. meningitidis was 72% (95% CI:63-79%), 88% (95% CI: 73-95%), and 81% (95% CI:67-92%), respectively.
  
  
  
  The LPA assay can be used to detect common bacterial meningitis pathogens in CSF samples, but the assay requires further improvement.
authors.affiliation: Division of Pediatric Infectious Diseases, Marmara University Medical Faculty Department of Pediatrics, Istanbul, Turkey. asoysal@marmara.edu.tr.|Division of Pediatric Infectious Diseases, Marmara University Pendik Training and Research Hospital Department of Pediatrics, Mimar Sinan Street, No:41, Fevzi Cakmak Mah. Ust Kaynarca, Pendik, Istanbul, Turkey. asoysal@marmara.edu.tr.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Soysal
authors.affiliation: University of Washington Seattle Children's Hospital, Seattle, USA.
authors.forename: Demet Gedikbasi
authors.initials: DG
authors.lastname: Toprak
authors.affiliation: Anadolu Medical Center, Kocaeli, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Türkoğlu
authors.affiliation: Division of Pediatric Infectious Diseases, Marmara University Medical Faculty Department of Pediatrics, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bakir
mesh_terms: D000293:Adolescent; D001419:Bacteria / Q000235:genetics* / Q000302:isolation & purification*; D015373:Bacterial Typing Techniques / Q000379:methods*; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial; D005260:Female; D019741:Haemophilus influenzae type b / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000382:microbiology*; D008583:Meningitis, Haemophilus / Q000453:epidemiology / Q000382:microbiology; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000382:microbiology; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000382:microbiology; D015336:Molecular Probe Techniques; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods; D009345:Neisseria meningitidis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000302:isolation & purification; D014421:Turkey / Q000453:epidemiology
chemical_list: D004269:DNA, Bacterial
keywords: Bacterial meningitis; Children; Line probe assay; National surveillence