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Lipkin paper investigating previously undetectable pathogens in central nervous system infections

Discussion in 'Other Health News and Research' started by Bob, Aug 21, 2013.

  1. Bob

    Bob

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    Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections
    Chien-Chin Hsu, Rafal Tokarz, Thomas Briese, Hung-Chin Tsai, Phenix-Lan Quan, and W. Ian Lipkin
    September 2013
    Emerg Infect Dis
    DOI: 10.3201/eid1909.130474
    http://wwwnc.cdc.gov/eid/article/19/9/13-0474_article.htm


    This seems to be a collaboration between the CDC, Lipin and colleagues of Lipkin.

    About lead author, Chien-Chin Hsu, the paper says:
    > Dr Hsu is a physician-scientist at Chi-Mei Medical Center, Tainan, Taiwan. A recent graduate of the doctoral program in epidemiology at the Mailman School of Public Health, Columbia University, he is dedicated to advancing infection control in Taiwan through the introduction of molecular diagnostics.

    I thought perhaps it might give some clues to some of the technology that Likpin & Hornig are using in the CFS study.


    They Investigated cerebrospinal fluid samples from patients with central nervous system (CNS) infections of unknown cause in 1 hospital in Taiwan:

    "We determined the infectious agent for 31 (24%) of 131 previously negative samples."


    Abstract
    No agent is implicated in most central nervous system (CNS) infections. To investigate cerebrospinal fluid samples from patients with CNS infections of unknown cause in 1 hospital in Taiwan, we used a staged molecular approach, incorporating techniques including multiplex MassTag PCR, 16S rRNA PCR, DNA microarray, and high-throughput pyrosequencing. We determined the infectious agent for 31 (24%) of 131 previously negative samples. Candidate pathogens were identified for 25 (27%) of 94 unexplained meningitis cases and 6 (16%) of 37 unexplained encephalitis cases. Epstein-Barr virus (18 infections) accounted for most of the identified agents in unexplained meningitis cases, followed by Escherichia coli (5), enterovirus (2), human herpesvirus 2 (1), and Mycobacterium tuberculosis. Herpesviruses were identified in samples from patients with unexplained encephalitis cases, including varicella-zoster virus (3 infections), human herpesvirus 1 (2), and cytomegalovirus (1). Our study confirms the power of multiplex MassTag PCR as a rapid diagnostic tool for identifying pathogens causing unexplained CNS infections.


    (The text that I've bolded seems relevant to CFS/ME.)
     
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  2. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    interesting, so just to confirm i understand this, prior to this new technique of diagnosing pathogens these patients infections werent picked up in normal blood work so the cause of the meningittis was unexplained until the multiplex tag PCR testing etc was used??
     
  3. Bob

    Bob

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    That's my interpretation as well, but I haven't read enough detail to know how new or novel their techniques are.
     
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  4. alex3619

    alex3619 Senior Member

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    I don't think the fundamentals of this technology are new. I think its about advances in how to combine various older technologies, and how to do so to enable simultaneous broad analysis. That is what is new(ish).
     
  5. Firestormm

    Firestormm Guest

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    I don't think so.

    Each of the patients studied had already been diagnosed and although it doesn't say so - let's assume were being treated:

    Pathogens were identified for some but not for others:

    So 16 out of 131 unidentified cases - what's that around 8%? - had EBV identified as the pathogen for their diagnosis of meningitis. Not sure how this might have changed the patient's treatment protocol - I don't know enough about the condition and the study doesn't seem to comment on the patient's state of health or if the presence of this pathogen is still likely to be affecting their health to a significant (directly related) degree; but:

     
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  6. Bob

    Bob

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    Thanks for the quotes, Firestormm.

    To summarise:

    "We determined the infectious agent for 31 (24%) of 131 previously negative samples."

    "25 [out of 31] were identified by MassTag PCR."

    They excluded cases of meningitis or encephalitis with noninfectious diagnosis:
    "CSF samples from meningitis or encephalitis patients with noninfectious diagnosis, including traumatic, metabolic, malignant, vascular, surgical, hypoxic, and toxic causes, were excluded."
     

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