Implementation of the Cepheid Xpert EV assay for rapid detection of enteroviral meningitis: experience of a tertiary care center and a technical review.

AIMS: Rapid molecular detection of enterovirus in cerebrospinal fluid (CSF) has revolutionized the diagnosis and treatment modalities of patients with meningitis and largely affected cost of unnecessary antibiotic use and length of stay in hospitals.

MATERIALS AND METHODS: Between January 2010 and July 2012, we tested 220 CSF samples on the GeneXpert DX real-time polymerase chain reaction system (by Cepheid) using the Xpert EV kit assays. In addition, we reported 14 sample results cross-validated with an external referral laboratory as well as the results of external proficiency testing.

RESULTS: Out of all tested samples, 19% were positive for enterovirus. Furthermore, all referred and proficiency testing specimens were concordant with the peer-reviewed and tested samples.

CONCLUSION: Implementation of the Cepheid Xpert EV assay for rapid detection of enteroviral meningitis has been successful in our laboratory. This molecular diagnostic test is currently utilized by our staff physicians as a major tool in assessment and management of patients with meningitis.