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Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid.

Publication ,  Journal Article
Hanson, KE; Alexander, BD; Woods, C; Petti, C; Reller, LB
Published in: J Clin Microbiol
March 2007

Most patients with herpes simplex virus (HSV) central nervous system (CNS) infection have abnormal cerebrospinal fluid (CSF) indices. Therefore, we implemented screening criteria based on CSF values and host immune status to guide testing. All CSF samples submitted for HSV PCR analysis from January 1999 through December 2004 were included in the study. Specimens from patients with human immunodeficiency virus, a history of transplants, an age of <2 years, a CSF white blood cell count of >5 cells/mm(3), or a protein level of >50 mg/dl were tested upon request. All other samples were rejected and frozen. To validate our screening criteria, rejected specimens were pooled and tested retrospectively. Electronic medical records were also reviewed. A total of 1,659 HSV PCR requests from 1,458 patients were screened. Of the 1,296 specimens (78.1%) accepted for testing, 1,213 were negative, 7 were positive for HSV type 1 (HSV-1), 26 were positive for HSV-2, and 50 had unavailable results. Sixteen requests were rejected because an alternative microbiologic diagnosis had been established. Of the 347 samples rejected based on criteria, 222 (64.0%) remained available for pooled testing. No HSV-1-positive samples were identified in the rejected specimens. Two rejected specimens tested positive for HSV-2 DNA, but both met acceptance criteria which had not been communicated to the laboratory. Few patients (7.8%) with rejected specimens were treated with acyclovir, which suggests a low clinical concern for HSV encephalitis. Acceptance criteria based on CSF parameters and host immune status saved time and cost and did not miss patients with HSV CNS infection. Communication between the clinician and the laboratory is imperative for a successful screening program.

Duke Scholars

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Published In

J Clin Microbiol

DOI

ISSN

0095-1137

Publication Date

March 2007

Volume

45

Issue

3

Start / End Page

721 / 724

Location

United States

Related Subject Headings

  • Simplexvirus
  • Polymerase Chain Reaction
  • Microbiology
  • Mass Screening
  • Infant, Newborn
  • Humans
  • Herpesvirus 2, Human
  • Herpes Simplex
  • DNA, Viral
  • Central Nervous System Viral Diseases
 

Citation

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Hanson, K. E., Alexander, B. D., Woods, C., Petti, C., & Reller, L. B. (2007). Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid. J Clin Microbiol, 45(3), 721–724. https://doi.org/10.1128/JCM.01950-06
Hanson, Kimberly E., Barbara D. Alexander, Christopher Woods, Cathy Petti, and L Barth Reller. “Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid.J Clin Microbiol 45, no. 3 (March 2007): 721–24. https://doi.org/10.1128/JCM.01950-06.
Hanson KE, Alexander BD, Woods C, Petti C, Reller LB. Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid. J Clin Microbiol. 2007 Mar;45(3):721–4.
Hanson, Kimberly E., et al. “Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid.J Clin Microbiol, vol. 45, no. 3, Mar. 2007, pp. 721–24. Pubmed, doi:10.1128/JCM.01950-06.
Hanson KE, Alexander BD, Woods C, Petti C, Reller LB. Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid. J Clin Microbiol. 2007 Mar;45(3):721–724.

Published In

J Clin Microbiol

DOI

ISSN

0095-1137

Publication Date

March 2007

Volume

45

Issue

3

Start / End Page

721 / 724

Location

United States

Related Subject Headings

  • Simplexvirus
  • Polymerase Chain Reaction
  • Microbiology
  • Mass Screening
  • Infant, Newborn
  • Humans
  • Herpesvirus 2, Human
  • Herpes Simplex
  • DNA, Viral
  • Central Nervous System Viral Diseases