Validation of multiplex PCR for the diagnosis of acute bacterial meningitis in culture negative cerebrospinal fluid

Sérgio Monteiro de Almeida; Libera Maria Dalla Costa; Christian Siebra; Lavinia Nery Villa Stangler Arend; Keite da Silva Nogueira

doi:10.1590/0004-282X20190028

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(04): 224-231
DOI: 10.1590/0004-282X20190028

Article

Validation of multiplex PCR for the diagnosis of acute bacterial meningitis in culture negative cerebrospinal fluid

Validação do PCR multiplex para o diagnóstico de meningite bacteriana aguda com cultura de liquido cefalorraquidiano negativa

Sérgio Monteiro de Almeida

¹Universidade Federal do Paraná, Complexo Hospital de Clínicas, Ambulatório de Neuroinfecção, Curitiba PR, Brasil;

²Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Virologia, Curitiba PR, Brasil;

,

Libera Maria Dalla Costa

³Faculdades Pequeno Príncipe, Curitiba PR, Brasil;

⁴Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba PR, Brasil;

,

Christian Siebra

⁵Laboratório Central do Estado do Paraná, Laboratório de Bacteriologia, Curitiba PR, Brasil;

,

Lavinia Nery Villa Stangler Arend

⁵Laboratório Central do Estado do Paraná, Laboratório de Bacteriologia, Curitiba PR, Brasil;

,

Keite da Silva Nogueira

⁶Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Bacteriologia, Curitiba PR, Brasil;

⁷Universidade Federal do Paraná, Departamento de Patologia, Curitiba PR, Brasil.

› Author Affiliations

Abstract

ABSTRACT

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.

RESUMO

Este estudo avaliou as características funcionais da reação em cadeia da polimerase (PCR) multiplex para amostras de líquido cefalorraquidiano (LCR) de pacientes com características celulares e bioquímicas de meningite bacteriana aguda e culturas de LCR positivas ou negativas.

Métodos: O PCR multiplex foi realizado em 36 amostras de LCR: meningite bacteriana aguda comprovada por cultura (n = 7), meningite bacteriana aguda com cultura negativa (n = 17), meningite linfocítica (n = 8) e LCR normal (n = 4). As características funcionais do PCR multiplex foram avaliadas para meningite bacteriana definitiva e provável, utilizando cultura positiva, características citológicas e bioquímicas do LCR como padrão-ouro.

Resultados: O PCR multiplex do LCR foi eficiente no grupo com características celulares e bioquímicas do LCR de meningite bacteriana, mas com cultura do LCR negativa. Este grupo demonstrou especificidade, valor preditivo positivo e eficiência altos.

Conclusões: Os autores concluíram que o PCR multiplex do LCR pode melhorar a velocidade e a precisão do diagnóstico de meningite bacteriana em um ambiente clínico como complemento aos ensaios imunológicos e bacteriológicos clássicos no LCR. Também é útil para meningite bacteriana aguda com cultura de LCR negativa.

Keywords:

Cerebrospinal fluid - meningitis - meningitis, bacterial - polymerase chain reaction

Palavras-chave:

Líquido cefalorraquidiano - meningite - meningite bacteriana - reação em cadeia da polimerase

Full Text

References

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