Sérgio Monteiro de Almeida1,2, Libera Maria Dalla Costa3,4, Christian Siebra5, Lavinia Nery Villa Stangler Arend5, Keite da Silva Nogueira6,7. 1. Universidade Federal do Paraná, Complexo Hospital de Clínicas, Ambulatório de Neuroinfecção, Curitiba PR, Brasil. 2. Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Virologia, Curitiba PR, Brasil. 3. Faculdades Pequeno Príncipe, Curitiba PR, Brasil. 4. Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba PR, Brasil. 5. Laboratório Central do Estado do Paraná, Laboratório de Bacteriologia, Curitiba PR, Brasil. 6. Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Bacteriologia, Curitiba PR, Brasil. 7. Universidade Federal do Paraná, Departamento de Patologia, Curitiba PR, Brasil.
Abstract
INTRODUCTION: This study evaluated the operational characteristics of the multiplex polymerase chain reaction (PCR) for cerebrospinal fluid (CSF) from patients with cellular and biochemical characteristics of acute bacterial meningitis and positive or negative CSF cultures. METHODS: Multiplex PCR was performed for 36 CSF samples: culture-proven acute bacterial meningitis (n = 7), culture-negative acute bacterial meningitis (n = 17), lymphocytic meningitis (n = 8), and normal CSF (n = 4). The operational characteristics of multiplex PCR were evaluated with definite and probable bacterial meningitis, using culture positive, cytological and biochemical CSF characteristics as the gold standard. RESULTS: Multiplex PCR for CSF was efficient in the group with CSF cellular and biochemical characteristics of acute bacterial meningitis but with a negative CSF culture. This group demonstrated high specificity, positive predictive value, and efficiency. CONCLUSIONS: Multiplex PCR for CSF can improve the speed and accuracy of acute bacterial meningitis diagnosis in a clinical setting as a complement to classical immunological and bacteriological assays in CSF. It is also useful for CSF culture-negative acute bacterial meningitis.
INTRODUCTION: This study evaluated the operational characteristics of the multiplex polymerase chain reaction (PCR) for cerebrospinal fluid (CSF) from patients with cellular and biochemical characteristics of acute bacterial meningitis and positive or negative CSF cultures. METHODS: Multiplex PCR was performed for 36 CSF samples: culture-proven acute bacterial meningitis (n = 7), culture-negative acute bacterial meningitis (n = 17), lymphocytic meningitis (n = 8), and normal CSF (n = 4). The operational characteristics of multiplex PCR were evaluated with definite and probable bacterial meningitis, using culture positive, cytological and biochemical CSF characteristics as the gold standard. RESULTS: Multiplex PCR for CSF was efficient in the group with CSF cellular and biochemical characteristics of acute bacterial meningitis but with a negative CSF culture. This group demonstrated high specificity, positive predictive value, and efficiency. CONCLUSIONS: Multiplex PCR for CSF can improve the speed and accuracy of acute bacterial meningitis diagnosis in a clinical setting as a complement to classical immunological and bacteriological assays in CSF. It is also useful for CSF culture-negative acute bacterial meningitis.