Evaluation of real-time reverse transcriptase PCR assays for detection of pandemic influenza A/H1N1 2009 virus.

摘要

We appreciate the letter by Basmaci and colleagues. However, we disagree with their assessment that the GeneXpert enterovirus (EV) reverse transcriptase PCR (RT-PCR) assay -"paradoxically constitutes a risk in rare cases of bacterial coin-fection."The clinical evaluation of a patient, as well as the interpretation of any laboratory result, must be made in the context of all available historical, clinical, and laboratory information. In the rare occurrences of EV-bacterial cerebrospinal fluid (CSF) coinfection, the bacterium-related clinical, laboratory, or historical findings are usually sufficient to dissuade the physician from discontinuing antibiotics. In their report, Sferra and Pa-cini note that the cytochemical analyses of the CSF of all patients revealed findings "typical of bacterial meningitis" and that the EVs made no contribution to the clinical pictures of the cases (7). Our review of the remaining reported cases of confirmed EV-bacterium coinfection revealed that in all but one, historical, clinical, or laboratory findings were present that were suggestive of bacterial meningitis (1-5, 9).