Rapid detection of enterovirus in cerebrospinal fluid by a fully-automated PCR assay is associated with improved management of aseptic meningitis in adult patients

BackgroundEnterovirus (EV) is the most frequent cause of aseptic meningitis (AM). Lack of microbiological documentation results in unnecessary antimicrobial therapy and hospitalization.ObjectivesTo assess the impact of rapid EV detection in cerebrospinal fluid (CSF) by a fully-automated PCR (GeneXpert EV assay, GXEA) on the management of AM.Study designObservational study in adult patients with AM. Three groups were analyzed according to EV documentation in CSF: group A = no PCR or negative PCR (n = 17), group B = positive real-time PCR (n = 20), and group C = positive GXEA (n = 22). Clinical, laboratory and health-care costs data were compared.ResultsClinical characteristics were similar in the 3 groups. Median turn-around time of EV PCR decreased from 60 h (IQR (interquartile range) 44–87) in group B to 5 h (IQR 4–11) in group C (p < 0.0001). Median duration of antibiotics was 1 (IQR 0–6), 1 (0–1.9), and 0.5 days (single dose) in groups A, B, and C, respectively (p < 0.001). Median length of hospitalization was 4 days (2.5–7.5), 2 (1–3.7), and 0.5 (0.3–0.7), respectively (p < 0.001). Median hospitalization costs were $5458 (2676–6274) in group A, $2796 (2062–5726) in group B, and $921 (765–1230) in group C (p < 0.0001).ConclusionsRapid EV detection in CSF by a fully-automated PCR improves management of AM by significantly reducing antibiotic use, hospitalization length and costs.     

A young-onset frontal dementia with dramatic calcifications due to a novel CSF1R mutation

ABSTRACT

Neuroimaging and genomic analysis greatly aid in the identification of young-onset dementia antemortem. We present the case of a 33-year-old female with a 2-year rapid decline to dementia and immobility marked by personality change, executive deficits including compulsions, attention deficit, apraxia, Parkinsonism, and pyramidal signs. She had unique and dramatic calcifications and confluent white matter changes on imaging and was found to have a novel mutation in the colony stimulating factor 1 receptor gene causing adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP). Here, we review ALSP and briefly discuss differential diagnoses.     

Common SNPs in CSF2RB are associated with major depression and schizophrenia in the Chinese Han population

Abstract

Objectives. Colony stimulating factor 2 receptor β (CSF2RB) encodes the protein which is the common β chain of the high affinity receptor for IL-3, IL-5 and CSF. It locates in the linkage region 22q12.3 of both bipolar disorder and schizophrenia, and is expressed in most cells. Methods. We carried out a large scale case–control study to test the association between CSF2RB and three major mental disorders in the Chinese Han population. Seven single nucleotide polymorphisms were genotyped in 1140 bipolar affective disorder patients (including 645 type I bipolar affective disorder patients), 1140 schizophrenia patients, 1139 major depressive disorder patients and 1140 healthy controls. Results. Three SNPs were found to be associated with both schizophrenia and major depressive disorder. Haplotype association analysis revealed one protective haplotype (P value = 0.014 for SCZ and 0.0004 for MDD) and one risk haplotype (P value = 0.006 for SCZ and 0.001 for MDD). Additional 52 SNPs were analyzed for population stratification, which demonstrated that our positive results were not caused by population stratification. Conclusions. Our results support CSF2RB as a risk factor common to both schizophrenia and major depression in the Chinese Han population.     

血清、脑脊液中S-100B在颅脑外伤损伤程度中的诊断意义

目的 探讨血清、脑脊液中S-100B与颅脑外伤(traumatic brain injury,TBI)损伤程度的关系.方法 选择45例TBI患者按格拉斯哥昏迷分级(GCS评分)分轻、中、重三组(病例组),采用酶联免疫吸附法(EHSA)测定TBI患者伤后第1、3、5、7天血清及脑脊液S-100B水平,并选择20例与病例组相匹配的疝或静脉曲张手术病人以及健康体检自愿者的血清、脑脊液作为对照组,分析血清及脑脊液S-100B水平与TBI损伤程度的相关性.结果 病例组血清、脑脊液S-100B水平较对照组明显升高(P ＜0.01;P ＜0.01);TBI患者GCS评分与血清及脑脊液S-100B水平比较呈负相关(r=-0.893,P＜0.01;r=-0.947,P＜0.01);血清、脑脊液S-100B在不同程度TBI间比较差异显著(P＜0.01);病例组血清和CSF中S-100B水平比较呈正相关;结论 血清、脑脊液S-100B测定均可作为判断TBI程度的指标,且各有特点.     

烟台地区病毒性脑炎病毒分离与病原学分析

目的了解烟台地区病毒性脑炎病原谱及其基因特征。方法采集烟台地区病毒性脑炎患者脑脊液46份及粪便标本10份,通过细胞培养分离病毒,RT-PCR扩增肠道病毒VP1区并测序,进行基因序列分析。结果从46例病毒性脑炎患者脑脊液标本中分离到11株病毒,分离率为23.91%,10份粪便标本中分离病毒5株。16株病毒经鉴定7株为肠道病毒,其中EV71型4株。EV71与其他地区流行株VP1区序列差异较小。结论烟台市病毒性脑炎以肠道病毒为主,有EV71型流行,与其他地区流行株相比,EV71型VP1区基因变异较小。