Comparison of Multiplex Quantitative Real-Time PCR and Culture Methods for the Diagnosis of Bacterial Meningitis in Patients with Suspected Meningitis

Background: This study aimed to compare the diagnostic efficacy of standard culture method with multiplex quantitative real-time polymerase chain reaction (qPCR) in examining cerebrospinal fluid (CSF) samples collected from patients with suspected meningitis. Materials & Methods: A retrospective evaluation was conducted on ۱۶۶ patients with suspected meningitis, who were treated in Vali-Asr hospital in Birjand, Iran between ۲۰۱۱ and ۲۰۲۰. Diagnosis of bacterial meningitis was based on CSF culture and multiplex qPCR results. Findings: Among ۱۶۶ patients, conventional methods identified causative pathogens in only ۱۰.۳% of cases, while multiplex qPCR detected pathogens in eight out of ۲۵ culture-negative cases as well. The most common pathogens identified were enterovirus, Epstein-Barr virus, herpes simplex, Haemophilus influenzae, and Streptococcus pneumoniae. Conclusion: Multiplex qPCR appears to be a more effective method than conventional culture in identifying bacterial and viral pathogens that most commonly cause meningitis. The incorporation of qPCR as a routine diagnostic method for meningitis in clinical practice could significantly enhance clinical decision-making and patient care.

Keywords:

Bacterial meningitis , Culture , Real time polymerase chain reaction