Dyal, J;
Akampurira, A;
Rhein, J;
Morawski, BM;
Kiggundu, R;
Nabeta, HW;
Musubire, AK;
Bahr, NC;
Williams, DA;
Bicanic, T;
et al.
Dyal, J; Akampurira, A; Rhein, J; Morawski, BM; Kiggundu, R; Nabeta, HW; Musubire, AK; Bahr, NC; Williams, DA; Bicanic, T; Larsen, RA; Meya, DB; Boulware, DR; ASTRO-CM Trial Team
(2016)
Reproducibility of CSF quantitative culture methods for estimating rate of clearance in cryptococcal meningitis.
Med Mycol, 54 (4).
pp. 361-369.
ISSN 1460-2709
https://doi.org/10.1093/mmy/myv104
SGUL Authors: Bicanic, Tihana
![[img]](https://openaccess.sgul.ac.uk/107610/7.hassmallThumbnailVersion/nihms776109.pdf) ![](https://openaccess.sgul.ac.uk/107610/7.haspreviewThumbnailVersion/nihms776109.pdf) Preview |
|
PDF
Accepted Version
Available under License ["licenses_description_publisher" not defined].
Download (1MB)
| Preview
|
Abstract
Quantitative cerebrospinal fluid (CSF) cultures provide a measure of disease severity in cryptococcal meningitis. The fungal clearance rate by quantitative cultures has become a primary endpoint for phase II clinical trials. This study determined the inter-assay accuracy of three different quantitative culture methodologies. Among 91 participants with meningitis symptoms in Kampala, Uganda, during August-November 2013, 305 CSF samples were prospectively collected from patients at multiple time points during treatment. Samples were simultaneously cultured by three methods: (1) St. George's 100 mcl input volume of CSF with five 1:10 serial dilutions, (2) AIDS Clinical Trials Group (ACTG) method using 1000, 100, 10 mcl input volumes, and two 1:100 dilutions with 100 and 10 mcl input volume per dilution on seven agar plates; and (3) 10 mcl calibrated loop of undiluted and 1:100 diluted CSF (loop). Quantitative culture values did not statistically differ between St. George-ACTG methods (P= .09) but did for St. George-10 mcl loop (P< .001). Repeated measures pairwise correlation between any of the methods was high (r≥0.88). For detecting sterility, the ACTG-method had the highest negative predictive value of 97% (91% St. George, 60% loop), but the ACTG-method had occasional (∼10%) difficulties in quantification due to colony clumping. For CSF clearance rate, St. George-ACTG methods did not differ overall (mean -0.05 ± 0.07 log10CFU/ml/day;P= .14) on a group level; however, individual-level clearance varied. The St. George and ACTG quantitative CSF culture methods produced comparable but not identical results. Quantitative cultures can inform treatment management strategies.
Item Type: |
Article
|
Additional Information: |
This is a pre-copyedited, author-produced version of an article accepted for publication in Medical Mycology following peer review. The version of record Jonathan Dyal, Andrew Akampurira, Joshua Rhein, Bozena M Morawski, Reuben Kiggundu, Henry W Nabeta, Abdu K Musubire, Nathan C Bahr, Darlisha A Williams, Tihana Bicanic, Robert A Larsen, David B Meya, David R Boulware, on behalf of the ASTRO-CM Trial Team; Reproducibility of CSF quantitative culture methods for estimating rate of clearance in cryptococcal meningitis, Medical Mycology, Volume 54, Issue 4, 1 May 2016, Pages 361–369 is available online at: https://doi.org/10.1093/mmy/myv104 |
Keywords: |
Cryptococcus, HIV/AIDS, accuracy, culture, meningitis, methodology, AIDS-Related Opportunistic Infections, Adult, Antifungal Agents, Cerebrospinal Fluid, Female, Humans, Limit of Detection, Male, Meningitis, Cryptococcal, Mycology, Prospective Studies, Severity of Illness Index, ASTRO-CM Trial Team, Cryptococcus, culture, methodology, HIV/AIDS, accuracy, meningitis, Cryptococcus, HIV/AIDS, accuracy, culture, meningitis, methodology, Microbiology, 1108 Medical Microbiology |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
Med Mycol |
ISSN: |
1460-2709 |
Language: |
eng |
Dates: |
Date | Event |
---|
May 2016 | Published | 14 January 2016 | Published Online | 19 November 2015 | Accepted |
|
Projects: |
Project ID | Funder | Funder ID |
---|
T32AI055433 | NIAID NIH HHS | UNSPECIFIED | U01 AI089244 | NIAID NIH HHS | UNSPECIFIED | R01 NS086312 | NINDS NIH HHS | UNSPECIFIED | R01NS086312 | NINDS NIH HHS | UNSPECIFIED | U01AI089244 | NIAID NIH HHS | UNSPECIFIED | R25TW009345 | FIC NIH HHS | UNSPECIFIED | T32 AI055433 | NIAID NIH HHS | UNSPECIFIED | R25 TW009345 | FIC NIH HHS | UNSPECIFIED |
|
PubMed ID: |
26768372 |
Web of Science ID: |
WOS:000374104800003 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/107610 |
Publisher's version: |
https://doi.org/10.1093/mmy/myv104 |
Statistics
Item downloaded times since 14 Sep 2018.
Actions (login required)
![Edit Item](/style/images/action_view.png) |
Edit Item |