Title : Diagnosis of suspicious skin lesions in mpox times
Abstract:
Background: The appearance of skin lesions of viral nature can be a symptom of infection or reactivation of the herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella zoster virus (VZV), T. pallidum or mpox virus infection. Given the ability of these pathogens to easily spread by contact, an accurate and fast diagnosis, such as PCR-based tests, is crucial for a successful epidemiological management. In the present study, the aim was to determine the clinical performance of three qPCR assays, as well as their usefulness for the joint characterisation of samples.
Material and methods: A total of 334 cutaneous swabs samples collected from patients with suspicion of infection attended at the Hospital Universitario Miguel Servet were analysed using the three assays under study: VIASURE Herpes virus 1, Herpes virus 2 & Varicella Zoster Virus Real Time PCR Detection Kit, VIASURE Treponema pallidum Real Time PCR Detection Kit and VIASURE Mpox Real Time PCR Detection Kit. Samples were collected between December 2021 and November 2022. These samples were requested through the Biobanco del Sistema de Salud de Aragón (BSSA) and the study has the authorization of the Aragón Ethics Committee (PI22/409). DNA/RNA extraction was performed using the automated extraction method magLEAD® 12gC instrument with the MagDEA Dx SV kit (Precision System Science Co.) and amplification was performed using CFX96TM Real-Time PCR Detection System (BioRad). The obtained results were compared with the reference assays RealStar® Orthopoxvirus PCR Kit 1.0 (Altona) for mpox virus detection and AllplexTM Genital ulcer assay (Seegene®) for HSV-1, HSV-2, VZV and T. pallidum detection.
Results: Based on the data analysis, a very good overall agreement was obtained for all the studied targets.
|
|
Overall agreement |
TP |
TN |
FP |
FN |
Sensitivity |
Specificity |
PPV |
NPV |
|
HSV-1 |
1 (0.98-1) |
49 |
285 |
0 |
0 |
1 (0.92-1) |
1 (0.98-1) |
1 (0.92-1) |
1 (0.98-1) |
|
HSV-2 |
1 (0.98-1) |
50 |
284 |
0 |
0 |
1 (0.92-1) |
1 (0.98-1) |
1 (0.92-1) |
1 (0.98-1) |
|
VZV |
1 (0.98-1) |
30 |
304 |
0 |
0 |
1 (0.88-1) |
1 (0.98-1) |
1 (0.88-1) |
1 (0.98-1) |
|
T. pallidum |
1 (0.98-1) |
35 |
299 |
0 |
0 |
1 (0.90-1) |
1 (0.98-1) |
1 (0.90-1) |
1 (0.98-1) |
|
Mpox virus |
1 (0.98-1) |
38 |
295 |
0 |
0 |
1 (0.90-1) |
1 (0.98-1) |
1 (0.90-1) |
1 (0.98-1) |
Conclusions: The assays under study prove to be a suitable tool for differential analysis in patients presenting skin lesions associated with suspected HSV-1, HSV-2, VZV, T. pallidum or mpox virus infection. Moreover, the shared thermal protocol of the assays allowed for the simultaneous detection in the sample, creating a customized panel option for the user, in contrast to the reference assays employed, which required two separated analyses, taking longer to reach the complete evaluation of the sample.
What will audience learn from your presentation?
- A new faster strategy for suspicious skin lesion swab diagnosis that provides a simultaneous differential analysis of HSV-1, HSV-2, VZV, T. pallidum or mpox virus infection.
- User can create personalized panel options by combining the different assays.
