Vu Thuy Duong1,2, Voong Vinh Phat2, Ha Thanh Tuyen2, Trần Thị Ngọc Dung2, Pham Duc Trung2, Pham Van Minh2, Le Thi Phuong Tu2, James Campbell3,2, Hoang Le Phuc1, Ton Thi Thanh Ha1, Minh Ngoc Nguyen4, Nguyễn Thị Hương4, Pham Thi Thanh Tam2, Dang Thao Huong2, Nguyen Van Xang5, Nguyễn Thị Đông5, Lê Thị Phượng6, Nguyễn Văn Hùng7, Bùi Đức Phú8, Tran My Phuc2, Guy Thwaites3,2, Lu Lan9, Maia A. Rabaa3,2, Corinne N. Thompson3,2, Stephen Baker3,2,10
1Children's Hospital 1, Ho Chi Minh City, Vietnam
2The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University, Clinical Research Unit, Ho Chi Minh City, Vietnam
3Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom
4Children's Hospital 2, Ho Chi Minh City, Vietnam
5Khanh Hoa General Hospital, Khanh Hoa, Vietnam
6Dong Thap General Hospital, Dong Thap, Vietnam
7Dak Lak General Hospital, Dak Lak, Vietnam
8Hue Central Hospital, Thua Thien Hue, Vietnam
9Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
10The London School of Hygiene and Tropical Medicine, London, United Kingdom
Tóm tắt
ABSTRACT
Diarrheal disease is a complex syndrome that remains a leading cause of global childhood morbidity and mortality. The diagnosis of enteric pathogens in a timely and precise manner is important for making treatment decisions and informing public health policy, but accurate diagnosis is a major challenge in industrializing countries. Multiplex molecular diagnostic techniques may represent a significant improvement over classical approaches. We evaluated the Luminex xTAG gastrointestinal pathogen panel (GPP) assay for the detection of common enteric bacterial and viral pathogens in Vietnam. Microbiological culture and real-time PCR were used as gold standards. The tests were performed on 479 stool samples collected from people admitted to the hospital for diarrheal disease throughout Vietnam. Sensitivity and specificity were calculated for the xTAG GPP for the seven principal diarrheal etiologies. The sensitivity and specificity for the xTAG GPP were >88% for
Shigella
spp.,
Campylobacter
spp., rotavirus, norovirus genotype 1/2 (GI/GII), and adenovirus compared to those of microbiological culture and/or real-time PCR. However, the specificity was low (∼60%) for
Salmonella
species. Additionally, a number of important pathogens that are not identified in routine hospital procedures in this setting, such as
Cryptosporidium
spp. and
Clostridium difficile
, were detected with the GPP. The use of the Luminex xTAG GPP for the detection of enteric pathogens in settings, like Vietnam, would dramatically improve the diagnostic accuracy and capacity of hospital laboratories, allowing for timely and appropriate therapy decisions and a wider understanding of the epidemiology of pathogens associated with severe diarrheal disease in low-resource settings.
