title: Evaluation of a TaqMan Array Card for Detection of Central Nervous System Infections.
abstract: Infections of the central nervous system (CNS) are often acute, with significant morbidity and mortality. Routine diagnosis of such infections is limited in developing countries and requires modern equipment in advanced laboratories that may be unavailable to a number of patients in sub-Saharan Africa. We developed a TaqMan array card (TAC) that detects multiple pathogens simultaneously from cerebrospinal fluid. The 21-pathogen CNS multiple-pathogen TAC (CNS-TAC) assay includes two parasites (Balamuthia mandrillarisandAcanthamoeba), six bacterial pathogens (Streptococcus pneumoniae,Haemophilus influenzae,Neisseria meningitidis,Mycoplasma pneumoniae,Mycobacterium tuberculosis, andBartonella), and 13 viruses (parechovirus, dengue virus, Nipah virus, varicella-zoster virus, mumps virus, measles virus, lyssavirus, herpes simplex viruses 1 and 2, Epstein-Barr virus, enterovirus, cytomegalovirus, and chikungunya virus). The card also includes human RNase P as a nucleic acid extraction control and an internal manufacturer control, GAPDH (glyceraldehyde-3-phosphate dehydrogenase). This CNS-TAC assay can test up to eight samples for all 21 agents within 2.5 h following nucleic acid extraction. The assay was validated for linearity, limit of detection, sensitivity, and specificity by using either live viruses (dengue, mumps, and measles viruses) or nucleic acid material (Nipah and chikungunya viruses). Of 120 samples tested by individual real-time PCR, 35 were positive for eight different targets, whereas the CNS-TAC assay detected 37 positive samples across nine different targets. The CNS-TAC assays showed 85.6% sensitivity and 96.7% specificity. Therefore, the CNS-TAC assay may be useful for outbreak investigation and surveillance of suspected neurological disease.
authors.affiliation: Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya xwl4@cdc.gov.
authors.forename: Clayton O
authors.initials: CO
authors.lastname: Onyango
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Loparev
authors.affiliation: Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Shirley
authors.initials: S
authors.lastname: Lidechi
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Vinod
authors.initials: V
authors.lastname: Bhullar
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: D Scott
authors.initials: DS
authors.lastname: Schmid
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Kay
authors.initials: K
authors.lastname: Radford
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Lo
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Rota
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Johnson
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Munoz
authors.affiliation: Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Martina
authors.initials: M
authors.lastname: Oneko
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Deron
authors.initials: D
authors.lastname: Burton
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Black
authors.affiliation: Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya.|Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: John
authors.initials: J
authors.lastname: Neatherlin
authors.affiliation: Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya.|Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Montgomery
authors.affiliation: Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya.|Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Fields
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D000369:Aged, 80 and over; D056894:Amoebozoa / Q000302:isolation & purification; D001419:Bacteria / Q000302:isolation & purification; D002494:Central Nervous System Infections / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008828:Microbiological Techniques / Q000379:methods*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014780:Viruses / Q000302:isolation & purification; D055815:Young Adult
keywords: TaqMan PCR; central nervous system; encephalitis; meningitis