A review of the role of Gastrointestinal Multiplex PCR in the management of Diarrheal illness

Background: Malaria is still a major health problem in Nepal as 43.3% of population are at risk of infection. However, the national priorities have been given to achieve malaria elimination in Nepal, the question of diagnostic accuracy could jeopardize the elimination target. Among others, multiplex PCR could be the reliable alternative tool to detect the low number of parasitemia and circulating asymptomatic infection in low endemic countries like Nepal. Hence, this paper aims to analyse the diagnostic precision among microscopy, rapid diagnostic test (RDT) and multiplex real time PCR assay. Methods: A total of 63 archived blood samples obtained from patient with clinical suspicion of malaria were subjected to multiplex PCR and their results were compared with microscopy and rapid diagnostic test. The Latent Class Analysis (LCA) approach was used to compare the diagnostic precision among three different assays. Results: Our study documented that PCR had 97.4% sensitivity and 83.9% specificity. Among the negative microscopy results, 10 (15.9%) were false negatives whereas 4 (6.3%) RDT results were false negatives based on PCR results. Conclusions: PCR could be the useful alternative tool to detect the low number of parasite in low endemic settings which could be crucial to rule out the false diagnosis determined by microscopy or RDT.

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Cryptosporidiosis.

Clinical Microbiology Reviews ◽

10.1128/cmr.4.3.325 ◽

1991 ◽

Vol 4 (3) ◽

pp. 325-358 ◽

Cited By ~ 331

Author(s):

W L Current ◽

L S Garcia

Keyword(s):

Case Reports ◽

Basic Research ◽

Diagnostic Techniques ◽

Biomedical Literature ◽

Unknown Etiology ◽

Diarrheal Illness ◽

Cryptosporidium Spp ◽

The Past ◽

Present Understanding

Before 1982, only eight case reports of human cryptosporidiosis and fewer than 30 papers on Cryptosporidium spp. appeared in the biomedical literature. At that time, cryptosporidiosis was thought to be an infrequent infection in animals and rarely an opportunistic infection in humans. The concept of Cryptosporidium spp. as pathogens has changed dramatically within the past 8 years because of improved diagnostic techniques, increased awareness within the biomedical community, and the development of basic research programs in numerous laboratories. Presently, greater than 1,000 publications including over 400 case reports in the biomedical literature address Cryptosporidium spp. and cryptosporidiosis. Cryptosporidium parvum is now thought to be one of the three most common enteropathogens causing diarrheal illness in humans worldwide, especially in developing countries. It is likely that cryptosporidiosis was previously included in the 25 to 35% of diarrheal illness with unknown etiology. Because of the severity and length of diarrheal illness and because no effective therapy has been identified, cryptosporidiosis is one of the most ominous infections associated with AIDS. The role of C. parvum as an enteropathogen is well established; documentation of its role as a cause of hepatobiliary and respiratory diseases is now appearing in the literature. Our present understanding of the natural history, epidemiology, biology, and immunology of Cryptosporidium spp. as well as the clinical features, pathogenicity, and treatment of cryptosporidiosis are reviewed here.

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Role of multiplex polymerase chain reaction in diagnosing tubercular meningitis

Journal of Laboratory Physicians ◽

10.4103/0974-2727.199633 ◽

2017 ◽

Vol 9 (02) ◽

pp. 145-147 ◽

Cited By ~ 4

Author(s):

Anupam Berwal ◽

Kiran Chawla ◽

Shashidhar Vishwanath ◽

Vishnu Prasad Shenoy

Keyword(s):

Polymerase Chain Reaction ◽

Multiplex Pcr ◽

Predictive Value ◽

Multiplex Polymerase Chain Reaction ◽

Extrapulmonary Tuberculosis ◽

Smear Microscopy ◽

Chain Reaction ◽

Polymerase Chain ◽

Sensitivity Specificity

AbstractTuberculous meningitis (TBM) is one of the most serious manifestations of extrapulmonary tuberculosis. Timely and accurate diagnosis provides a favorable prognosis in patients with TBM. The study evaluated the use of multiplex polymerase chain reaction (PCR) in the diagnosis of TBM. A study was conducted on 74 patients clinically suspected with TBM. The cerebrospinal fluid (CSF) specimens were processed for smear microscopy, middle brook 7H9 culture, and multiplex PCR using primers directed against IS6110 gene and 38 kD protein for detection of Mycobacterium tuberculosis. The results were analyzed to assess the role of multiplex PCR in the diagnosis of TBM. A total of 26 (35.1%) patients were diagnosed with TBM. Microscopy was negative in all while culture was positive in two cases only. Comparing with clinical diagnosis and CSF adenosine deaminase levels of ≥ 10 U/L, multiplex PCR showed sensitivity, specificity, positive predictive value, and negative predictive value of 71.4%, 89.6%, 83.3%, and 81.2%, respectively, in the diagnosis of TBM.

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