Evaluation of Viral and Bacterial Pathogens in the Central Nervous System Infections with Multiplex PCR

Objective: To evaluate the bacterial and viral causes of central nervous system (CNS) infection by multiplex PCR.Study Design: Descriptive study.Place and Duration of Study: Department of Medical Microbiology, Pamukkale University Faculty of Medicine, Turkey, from March 2016 to December 2021.Methodology: Cerebrospinal fluid (CSF) samples of patients prediagnosed with CNS infection were included in the study. Viral pathogens were detected with the Multiplex real-time PCR panel (FTD Neuro9, Fast Track Diagnostics, Luxembourg) and bacte-rial pathogens with the multiplex real-time PCR panel (FTD Bacterial Meningitis, Fast Track Diagnostics, Luxembourg). The iden-tification of bacteria growing in samples was done by conventional methods and with the PhoenixTM (Becton Dickinson Diagnos-tics, USA) automated system.Results: CSF samples of 440 patients were evaluated using multiplex PCR panel. The viral factors included adenovirus (14.2%), human herpes virus 7 (1.5%), varicella zoster virus (1.3%), herpes simplex virus 1 (1.3%), cytomegalovirus (1.3%), Epstein-Barr virus (0.8%), human herpes virus (0.8%), herpes simplex virus 2 (0.3%), varicella zoster virus (0.3%), and parvovirus B19 (0.3%); and bacterial factors included Streptococcus pneumoniae (7.0%) and Neisseria meningitidis (0.9%). The bacterial growth was detected in the CSF culture was 4.9%. Among the growing bacteria, there were six different types that were not found on the multiplex PCR panel. Conclusion: The use of a comprehensive bacterial multiplex PCR panel containing common pathogens will be more effective in pathogen detection. Care should be taken, especially when interpreting the viral Multiplex PCR.

Automated summary

This study aimed to evaluate the bacterial and viral causes of central nervous system (CNS) infection using multiplex PCR. The results showed that using a comprehensive bacterial multiplex PCR panel containing common pathogens could be more effective in pathogen detection. Care should be taken when interpreting the viral multiplex PCR results.