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Evaluation of the GeneXpert for Human Monkeypox Diagnosis.
Am J Trop Med Hyg. 2017 02 08; 96(2):405-410.AJ

Abstract

Monkeypox virus (MPXV), a zoonotic orthopoxvirus (OPX), is endemic in the Democratic Republic of Congo (DRC). Currently, diagnostic assays for human monkeypox (MPX) focus on real-time quantitative polymerase chain reaction (PCR) assays, which are typically performed in sophisticated laboratory settings. Herein, we evaluated the accuracy and utility of a multiplex MPX assay using the GeneXpert platform, a portable rapid diagnostic device that may serve as a point-of-care test to diagnose infections in endemic areas. The multiplex MPX/OPX assay includes a MPX-specific PCR test, OPX-generic PCR test, and an internal control PCR test. In total, 164 diagnostic specimens (50 crusts and 114 vesicular swabs) were collected from suspected MPX cases in Tshuapa Province, DRC, under national surveillance guidelines. The specimens were tested with the GeneXpert MPX/OPX assay and an OPX PCR assay at the Institut National de Recherche Biomedicale (INRB) in Kinshasa. Aliquots of each specimen were tested in parallel with a MPX-specific PCR assay at the Centers for Disease Control and Prevention. The results of the MPX PCR were used as the gold standard for all analyses. The GeneXpert MPX/OPX assay performed at INRB had a sensitivity of 98.8% and specificity of 100%. The GeneXpert assay performed well with both crust and vesicle samples. The GeneXpert MPX/OPX test incorporates a simple methodology that performs well in both laboratory and field conditions, suggesting its viability as a diagnostic platform that may expand and expedite current MPX detection capabilities.

Authors+Show Affiliations

Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo.Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.Ministry of Health, Kinshasa, Democratic Republic of Congo.University of Kinshasa, Kinshasa, Democratic Republic of Congo.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.BioGX, Birmingham, Alabama.Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo.Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo.Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo.Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, Democratic Republic of Congo.Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Enteric and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27994107

Citation

Li, Daniel, et al. "Evaluation of the GeneXpert for Human Monkeypox Diagnosis." The American Journal of Tropical Medicine and Hygiene, vol. 96, no. 2, 2017, pp. 405-410.
Li D, Wilkins K, McCollum AM, et al. Evaluation of the GeneXpert for Human Monkeypox Diagnosis. Am J Trop Med Hyg. 2017;96(2):405-410.
Li, D., Wilkins, K., McCollum, A. M., Osadebe, L., Kabamba, J., Nguete, B., Likafi, T., Balilo, M. P., Lushima, R. S., Malekani, J., Damon, I. K., Vickery, M. C. L., Pukuta, E., Nkawa, F., Karhemere, S., Tamfum, J. M., Okitolonda, E. W., Li, Y., & Reynolds, M. G. (2017). Evaluation of the GeneXpert for Human Monkeypox Diagnosis. The American Journal of Tropical Medicine and Hygiene, 96(2), 405-410. https://doi.org/10.4269/ajtmh.16-0567
Li D, et al. Evaluation of the GeneXpert for Human Monkeypox Diagnosis. Am J Trop Med Hyg. 2017 02 8;96(2):405-410. PubMed PMID: 27994107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the GeneXpert for Human Monkeypox Diagnosis. AU - Li,Daniel, AU - Wilkins,Kimberly, AU - McCollum,Andrea M, AU - Osadebe,Lynda, AU - Kabamba,Joelle, AU - Nguete,Beatrice, AU - Likafi,Toutou, AU - Balilo,Marcel Pie, AU - Lushima,Robert Shongo, AU - Malekani,Jean, AU - Damon,Inger K, AU - Vickery,Michael C L, AU - Pukuta,Elisabeth, AU - Nkawa,Frida, AU - Karhemere,Stomy, AU - Tamfum,Jean-Jacques Muyembe, AU - Okitolonda,Emile Wemakoy, AU - Li,Yu, AU - Reynolds,Mary G, Y1 - 2016/12/19/ PY - 2016/07/11/received PY - 2016/10/27/accepted PY - 2016/12/21/pubmed PY - 2017/6/1/medline PY - 2016/12/21/entrez SP - 405 EP - 410 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 96 IS - 2 N2 - Monkeypox virus (MPXV), a zoonotic orthopoxvirus (OPX), is endemic in the Democratic Republic of Congo (DRC). Currently, diagnostic assays for human monkeypox (MPX) focus on real-time quantitative polymerase chain reaction (PCR) assays, which are typically performed in sophisticated laboratory settings. Herein, we evaluated the accuracy and utility of a multiplex MPX assay using the GeneXpert platform, a portable rapid diagnostic device that may serve as a point-of-care test to diagnose infections in endemic areas. The multiplex MPX/OPX assay includes a MPX-specific PCR test, OPX-generic PCR test, and an internal control PCR test. In total, 164 diagnostic specimens (50 crusts and 114 vesicular swabs) were collected from suspected MPX cases in Tshuapa Province, DRC, under national surveillance guidelines. The specimens were tested with the GeneXpert MPX/OPX assay and an OPX PCR assay at the Institut National de Recherche Biomedicale (INRB) in Kinshasa. Aliquots of each specimen were tested in parallel with a MPX-specific PCR assay at the Centers for Disease Control and Prevention. The results of the MPX PCR were used as the gold standard for all analyses. The GeneXpert MPX/OPX assay performed at INRB had a sensitivity of 98.8% and specificity of 100%. The GeneXpert assay performed well with both crust and vesicle samples. The GeneXpert MPX/OPX test incorporates a simple methodology that performs well in both laboratory and field conditions, suggesting its viability as a diagnostic platform that may expand and expedite current MPX detection capabilities. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/27994107/Evaluation_of_the_GeneXpert_for_Human_Monkeypox_Diagnosis_ L2 - https://ajtmh.org/doi/10.4269/ajtmh.16-0567 DB - PRIME DP - Unbound Medicine ER -