Comparison of culture and PCR methods in the diagnosis of bacterial meningitis

Abstract

Our aim in this study is to compare the standard culture method with the multiplex PCR and the Speed-Oligo® Bacterial Meningitis Test (SO-BMT) – a hybridization-based molecular test method – during the CSF examination of the patients with the pre-diagnosis of acute bacterial meningitis. For the purposes of this study, patients with acute bacterial meningitis treated at the Dicle University Medical Faculty Hospital, Infectious Diseases and Clinical Microbiology Clinic between December 2009 and April 2012 were retrospectively evaluated. The diagnosis of bacterial meningitis was made based on the clinical findings, laboratory test anomalies, CSF analysis results, and the radiological images. Growth was observed in the CSF cultures of 10 out of the 57 patients included in the study (17.5%) and Streptococcus pneumoniae was isolated in all of them. The CSF samples of 34 patients (59.6%) were positive according to the SO-BMT and S. pneumoniae was detected in 33 of the samples (97.05%), while Neisseria meningitidis was found in 1 sample (2.95%). In a total of 10 patients, S. pneumoniae was both isolated in the CSF culture and detected in the SO-BMT. The culture and the SO-BMT were negative in 23 of the CSF samples. There was no sample in which the CSF culture was positive although the SO-BMT was negative. While SO-BMT seems to be a more efficient method than bacterial culturing to determine the pathogens that most commonly cause bacterial meningitis in adults, further studies conducted on larger populations are needed in order to assess its efficiency and uses.

Bacteria and Antibiotic Susceptibility Patterns of Cerebrospinal Fluid Isolated in Children with Bacterial Meningitis at Sanglah Hospital, Bali from 2016 to 2018

“…Nucleic acid amplification tests such as the polymerase chain reaction (PCR) can detect small amounts of pathogen DNA independently from the growth of the microorganism causing the disease. [8] Wang et al also identified bacterial meningitis in five cases (9%) by CSF cultures and 25 (45%) by real-time PCR. They considered real-time PCR much more sensitive than culture for the diagnosis of bacterial meningitis particularly in their study where 68% of patients had received prior antimicrobial treatment and their CSF samples yielded negative culture results.…”

“…The fact that most patients received antimicrobial agents that are readily purchased as over the counter medications even prior to clinical evaluation alongside the occasional delay in CSF sampling, resulting in germ patterns obtained that do not reflect the real result. [8] Besides, according to Brouwer et al, CSF culture is documented to be positive only in 1/10 of the previously antibiotic treated patients in developing countries. [9] Same result was found by Afifi et al who reported low rates of culture positive CSF samples (8%) of suspected cases with bacterial meningitis.…”

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

“…Alternative methods of molecular identification, including 16S/23S rRNA gene amplification, followed by sequencing and real time PCR, have been developed 7 . Several multiplex PCR assays for the simultaneous detection of S. pneumoniae, H. influenzae, and N. meningitidis have been established 22,23,24,25,26 . However, their application as a first-line diagnostic test remains controversial 25,26,27 .…”

Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis

“…Diagnosis was based on history, clinical criteria, and CSF examination criteria. 3 , 7 , 8 , 9 , 10 According to diagnosis and therapeutic outcome, the study population was classified into three groups: Group I included 30 patients diagnosed with ABM, Group II 30 patients were diagnosed with non-bacterial (mostly viral) meningitis, and, finally, Group III included 30 subjects with normal CSF examination findings (control group).…”