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Volume 27, Number 1—January 2021
Research

Viral Metagenomic Analysis of Cerebrospinal Fluid from Patients with Acute Central Nervous System Infections of Unknown Origin, Vietnam

Nguyen To AnhComments to Author , Le Nguyen Truc Nhu, Nguyen Thi Thu Hong, Tran My Phuc, Pham Thi Thanh Tam, Dang Thao Huong, Tran Tuan Anh, Xutao Deng, Ho Dang Trung Nghia, Tran Thua Nguyen, Nguyen Van Hung, Nguyen Dac Thuan, Pham Thi Hong Phuong, Nguyen Van Vinh Chau, Stephen Baker, Eric Delwart, Guy Thwaites, Le Van TanComments to Author , and for the VIZIONS Consortium1
Author affiliations: Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam (N.T. Anh, L.N.T. Nhu, N.T.T. Hong, T.M. Phuc, P.T.T. Tam, D.T. Huong, T.T. Anh, H.D.T. Nghia, G. Thwaites, L.V. Tan); Hue Central Hospital, Hue City, Vietnam (T.T. Nguyen); Dak Lak General Hospital, Ban Me Thuot City, Vietnam (N.V. Hung); Khanh Hoa General Hospital, Nha Trang City, Vietnam (N.D. Thuan); Dong Thap General Hospital, Dong Thap, Vietnam (P.T.H. Phuong); Vitalant Research Institute, San Francisco, California, USA (X. Deng, E. Delwart); University of California Department of Laboratory Medicine, San Francisco (X. Deng, E. Delwart); Pham Ngoc Thach University, Ho Chi Minh City (H.D.T. Nghia); Hospital for Tropical Diseases, Ho Chi Minh City (N.V.V. Chau); University of Cambridge Institute of Therapeutic Immunology and Infectious Disease, Cambridge, UK (S. Baker); Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK (S. Baker, G. Thwaites)

Main Article

Table

Baseline characteristics and clinical data of patients with acute central nervous system infections enrolled for mNGS analysis of CSF samples, Vietnam, December 2012–October 2016*

Characteristic Patients with unknown cause enrolled for mNGS, n = 204 Patients with mNGS negative, n = 174 Patients with enterovirus detected, n = 23 p value†
Sex
M 135 (66) 114 (65.5) 15 (65)
F
69 (34)
60 (34.5)
8 (35)

Age, y, median (range)
20.5 (0–92)
24 (0–92)
13 (2–27)
0.005
Location
Hue 37 (18) 28 (16) 9 (39)
Dak lak 98 (48) 87 (50) 10 (43.5)
Khanh Hoa 28 (14) 22 (13) 4 (17.5)
Dong Thap
41 (20)
37 (21)
0

3-d fever (at enrollment or preceding 3 d)
Fever 148 (72.5) 126 (72.4) 17 (74) 0.054
Temperature, C°, median (range) 39 (37.5–42.0) 39 (37.5–42.0) 38.5 (38.0–40.5)
Fever with unknown temperature 29 (14.2) 22 (12.6) 6 (26)
No fever 20 (9.8) 19 (11) 0
Unknown
7 (3.5)
7 (4)
0

Outcome
Death or discharge to die 22 (11) 22 (12.6) 0
Discharge with complete recovery 108 (53) 86 (49.4) 18 (78.3)
Discharge with incomplete recovery 35 (17) 31 (17.8) 2 (8.7)
Transfer to another hospital 34 (16.5) 30 (17.2) 3 (13)
Other (patient request) 3 (1.5) 3 (1.7) 0
Unknown
2 (1)
2 (1.3)
0

CSF white cells, cells/mm3 median (min–max) 88.5 (5–40,000) 71.5 (5–40,000) 110 (8–1200) 0.343

*Values are no. (%) except as indicated, CSF, cerebrospinal fluid; mNGS, metagenomic next-generation sequencing.
†Statistical comparisons were performed for groups of patients with mNGS-negative results and enterovirus detected, by Mann-Whiney test.

Main Article

1Members are listed at the end of this article.

Page created: November 24, 2020
Page updated: December 21, 2020
Page reviewed: December 21, 2020
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