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Cited by 13Bacterial Infections and VaccinesBacterial Identification and Susceptibility TestingInfectious Diseases and Tuberculosis

Frequency of etiological agents of acute bacterial meningitis using culture and polymerase chain reaction assay

Open access
Zeighami, H., Roudashti, S., Bahari, Sh., Haghi, F., Hesami, N.·2021·New Microbes and New Infections
DOI 10.1016/j.nmni.2021.100930PMC PMC8414167
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Abstract

Bacterial meningitis is one of the most severe infectious diseases with high rate of morbidity and mortality in developing countries. The current study aimed to investigate the frequency of etiological agents of bacterial meningitis among patients admitted to three hospitals in Zanjan, Iran. A total of 100 cerebrospinal fluid (CSF) samples were collected aseptically, and cytochemical analysis, Gram staining, culture, and PCR were performed. Forty-six percent of CSF samples had positive bacterial culture results. However, PCR showed a higher detection rate of bacterial meningitis causing pathogens when compared with culture (52% vs. 46%; p > 0.05). Fifty-two percent of patients with bacterial meningitis were aged <1 year. The most prevalent pathogen was Streptococcus pneumoniae (36.5%), followed by Neisseria meningitidis (28.8%) and Streptococcus agalactiae (15.4%). Listeria monocytogenes was not isolated from CSF culture. The frequency of Haemophilus influenzae, L. monocytogenes and Escherichia coli was 7.7%, 1.9% and 9.6%, respectively. Although in patients aged <1 year, S. pneumonia, N. meningitidis and group B streptococcus were the most common pathogens causing meningitis, and in patients aged between 1 and 10 years, Escherichia coli was the most common. According to the results, the culture was less effective for diagnosis of bacterial meningitis than PCR. Our findings indicate that the most common causative agents of bacterial meningitis in Iran may be vaccine-preventable pathogens. Therefore, the prevention and control measures should be considered to reduce the incidence of bacterial meningitis.

AI snapshot

Written from the paper’s full text.

TL;DR

In 100 CSF samples from suspected bacterial meningitis patients in Zanjan, Iran, PCR detected bacterial pathogens in 52% versus 46% by culture (p > 0.05). The most common agents were *Streptococcus pneumoniae* (36.5%), *Neisseria meningitidis* (28.8%), and *Streptococcus agalactiae* (15.4%), with most cases in children aged <1 year.

Key findings

  • PCR was positive in 52% of CSF samples and culture in 46%; 46% were positive by both, and 6% were positive only by PCR (p > 0.05).
  • Among PCR-positive samples, the most prevalent pathogens were *S. pneumoniae* (36.5%), *N. meningitidis* (28.8%), and *S. agalactiae* (15.4%); *H. influenzae* was 7.7%, *E. coli* 9.6%, and *L. monocytogenes* 1.9%.
  • *L. monocytogenes* was not isolated by culture; PCR detected it in 1 sample. All eight *S. agalactiae* cases were aged <1 year, and all *E. coli* cases were aged 1–10 years.
  • In patients aged <1 year, *S. pneumoniae*, *N. meningitidis*, and group B streptococcus were the most common; in those aged 1–10 years, *E. coli* was the most common.

Methods

  • Between March 2016 and February 2017, 100 CSF samples were collected from suspected bacterial meningitis patients admitted to three major university hospitals in Zanjan, Iran; inclusion/exclusion criteria are summarized in Table 1.
  • CSF underwent cytochemical analysis, Gram staining, culture on blood/chocolate/MacConkey agar, and PCR. DNA extraction used the QIAGEN DNA Mini kit with modified lysozyme lysis; simplex PCR targeted *ply* (*S. pneumoniae*), *ctrA* (*N. meningitidis*), *bexA* (*H. influenzae*), *prf* (*L. monocytogenes*), *meth* (*E. coli*), and *cyl* (*S. agalactiae*).
  • Data were analyzed with SPSS v17.0; Wilcoxon-Mann-Whitney and chi-square tests were used, with p < 0.05 considered significant.

Limitations

  • Stated: PCR inhibitors in clinical specimens (e.g., IgG in blood) can reduce amplification efficacy and may explain imperfect PCR sensitivity; 48% of CSF samples were negative for the investigated bacteria, suggesting viruses, parasites, or other bacterial agents.
  • Stated: molecular typing of *H. influenzae* was not performed, so type b and non-type b strains could not be discriminated; it is unclear whether *L. monocytogenes* is truly not prevalent in Iran or whether standard isolation techniques are lacking.
  • Evident: single-region, single-year, 100-sample hospital-based study limits generalizability; the culture-versus-PCR difference was not statistically significant (p > 0.05).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.nmni.2021.100930

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 25 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    S. agalactiae (15.4%) was the third most common causative agent of meningitis.

    “Our finding showed that S. agalactiae (15.4%) was the third most common causative agent of meningitis.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Listeria monocytogenes was not isolated from CSF culture.

    “Listeria monocytogenes was not isolated from CSF culture.”
    • Also stated in: § Discussion · plain
      “In our study, L. monocytogenes was not isolated from CSF culture, and PCR assay showed that only one CSF sample was PCR positive.”
    Quote in the paperNot a substantial claim
  • Findingown data

    PCR showed a good correlation between culture and PCR.

    “According to our results, PCR (52%) had a higher positive rate than CSF culture (46%; p > 0.05), and it showed a good correlation between culture and PCR.”
    Quote in the paperSubstantial claim
  • Findingown data

    46% of CSF samples were positive by both culture and PCR.

    “Also, 46% of CSF samples were positive by both culture and PCR, and 6% were positive only by PCR.”
    Quote in the paperNot a substantial claim
  • Findingown data

    All patients with E. coli meningitis were aged 1-10 years.

    “All patients with E. coli meningitis were aged 1–10 years.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 19

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sex distribution was 52% male and 48% female.

    “The sex distribution was 52% male and 48% female.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In patients aged <1 year, S. pneumonia, N. meningitidis and group B streptococcus were the most common pathogens causing meningitis, and in patients aged between 1 and 10 years, Escherichia coli was the most common.

    “Although in patients aged <1 year, S. pneumonia, N. meningitidis and group B streptococcus were the most common pathogens causing meningitis, and in patients aged between 1 and 10 years, Escherichia coli was the most common.”
    • Also stated in: § Results · plain
      “While in patients aged <1 year, S. pneumonia, N. meningitidis and group B streptococcus were the most common pathogens causing bacterial meningitis, and in patients aged between 1 and 10 years, E. coli was the most common.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The frequency of Haemophilus influenzae, L. monocytogenes and Escherichia coli was 7.7%, 1.9% and 9.6%, respectively.

    “The frequency of Haemophilus influenzae, L. monocytogenes and Escherichia coli was 7.7%, 1.9% and 9.6%, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Of 52 patients with bacterial meningitis, 30 (57.7%) were aged <1 year, 10 (19.2%) were aged 1-10 years, 6 (11.5%) were aged 10-30 years and 6 (11.5%) were aged >30 years.

    “Of 52 patients with bacterial meningitis, 30 patients (57.7%) were aged <1 year, ten patients (19.2%) were aged 1–10 years, six patients (11.5%) were aged 10–30 years and six patients (11.5%) were aged >30 years.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the positive bacterial cultures, 25 isolates (54.3%) were Gram-positive cocci and 21 (45.6%) were Gram-negative bacilli.

    “Forty-six percent of CSF samples had positive bacterial culture, of which 25 isolates (54.3%) were Gram-positive cocci and 21 (45.6%) were also Gram-negative bacilli.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In our study, L. monocytogenes was not isolated from CSF culture, and PCR assay showed that only one CSF sample was PCR positive.

    “In our study, L. monocytogenes was not isolated from CSF culture, and PCR assay showed that only one CSF sample was PCR positive.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The most prevalent pathogen was Streptococcus pneumoniae (36.5%), followed by Neisseria meningitidis (28.8%) and Streptococcus agalactiae (15.4%).

    “The most prevalent pathogen was Streptococcus pneumoniae (36.5%), followed by Neisseria meningitidis (28.8%) and Streptococcus agalactiae (15.4%).”
    • Also stated in: § Results · plain
      “The most prevalent pathogen was S. pneumoniae (36.5%), followed by N. meningitidis (28.8%) and S. agalactiae (15.4%).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Fever, leukocytosis, headache, nausea and vomiting were the most common clinical manifestations of bacterial meningitis in our study.

    “Fever, leukocytosis, headache, nausea and vomiting were the most common clinical manifestations of bacterial meningitis in our study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among the total patients, 52% were aged <1 year, 24% were aged 1-10 years, 13% were aged 10-30 years and 11% were aged >30 years.

    “Among the total patients, 52% of patients were aged <1 year, 24% were aged 1–10 years, 13% were aged 10–30 years and 11% were aged >30 years.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Gram stain is more rapid and has good specificity, but sensitivity is poor (10-93% depending on the organism and whether or not antibiotics were given before CSF collection).

    “Gram stain is more rapid and has good specificity, but sensitivity is poor (10–93% depending on the organism and whether or not antibiotics were given before CSF collection) [6].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Poplin, 2020, Methods for rapid diagnosis of meningitis etiology in adults, Biomark Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    Viruses, parasites and other bacterial agents might be causing meningitis in the 48% of CSF samples negative for the investigated bacteria.

    “This likely suggests that viruses, parasites and other bacterial agents might be causing meningitis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In studies conducted in the United Kingdom, investigators have been able to confirm 56% more cases of invasive meningococcal disease with PCR than with culture.

    “They have been able to confirm 56% more cases of invasive meningococcal disease with PCR than with culture [4].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Richardson, 2003, Evaluation of a rapid PCR assay for diagnosis of meningococcal meningitis, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Universal PCR based on the amplification of conserved regions of 16S rRNA gene has been used for detecting and differentiating of broad range of bacterial agents of meningitis, but its performance varies in different studies, probably because of different methodologies.

    “Universal PCR based on the amplification of conserved regions of 16S rRNA gene has been used for detecting and differentiating of broad range of bacterial agents of meningitis. However, the performance of 16S rRNA PCR varies in different studies, probably because of different methodologies [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Poplin, 2020, Methods for rapid diagnosis of meningitis etiology in adults, Biomark Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    According to previous studies, the frequency of S. pneumoniae was 31.7-73.8%.

    “According to previous studies, the frequency of S. pneumoniae was 31.7–73.8% [12,12, 17].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] Nhantumbo, 2015, Frequency of pathogenic paediatric bacterial meningitis in Mozambique: the critical role of multiplex real-time polymerase chain reaction to estimate the burden of disease, PLoS One source

      Not checked in the free run.

    • cites [17] Houri, 2017, Acute bacterial meningitis in Iran: systematic review and meta-analysis, PLoS One source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    According to Houri et al. meta-analysis, the frequency of pneumococcal meningitis in children aged <10 years and individuals aged >10 years in Iran was 36% and 20%, respectively.

    “According to Houri et al. meta-analysis, the frequency of pneumococcal meningitis in children aged <10 years and individuals aged >10 years in Iran was 36% and 20%, respectively [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Houri, 2017, Acute bacterial meningitis in Iran: systematic review and meta-analysis, PLoS One source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    PCR assay is a more accurate and rapid diagnostic tool for bacterial meningitis.

    “According to our results, PCR assay is a more accurate and rapid diagnostic tool for bacterial meningitis.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: CSF culture is only positive in 70–85% of patients who have not received antimicrobial therapy before lumbar puncture.
    • Rests on an assumption: Final results of the culture are often not available for ≥48 h.
    • Rests on an assumption: The positive rate of CSF culture is relatively low because of suboptimal storage and transportation conditions and culture practice.

  • May combine two claims.

    Premisecitation

    Because of the lack of a routine vaccination programme against meningeal pathogens in Iran, acute bacterial meningitis is considered as a serious problem in health care settings with high rate of morbidity and mortality.

    “On the other hand, because of the lack of a routine vaccination programme against meningeal pathogens in Iran, acute bacterial meningitis is considered as a serious problem in health care settings with high rate of morbidity and mortality [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Houri, 2017, Acute bacterial meningitis in Iran: systematic review and meta-analysis, PLoS One source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    PCR-based assays of CSF are a rapid, sensitive, direct and specific diagnostic test for bacterial meningitis.

    “PCR-based assays of CSF have been suggested as a rapid, sensitive, direct and specific diagnostic test for bacterial meningitis.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Schiess, 2021, The Impact and burden of neurological sequelae following bacterial meningitis: a narrative review, Microorganisms source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the recent decade, S. pneumoniae has been considered as the main causative agent of bacterial meningitis in children aged <10 years, in elder population, and in immunocompromised patients in the United States and European countries.

    “In the recent decade, S. pneumoniae has been considered as the main causative agent of bacterial meningitis in children aged <10 years, in elder population, and in immunocompromised patients in the United States and European countries [16].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Hoffman, 2009, Pathophysiology and treatment of bacterial meningitis, Ther Adv Neurol Disord source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Clinical application of PCR may help to reduce the potential risk of delay in antimicrobial therapy of meningitis.

    “So, the clinical application of this technique may help to reduce the potential risk of delay in antimicrobial therapy of meningitis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The variation in S. pneumoniae frequency may be because of the performance of pneumococcal vaccination programme in some countries, patients' age, diagnostic approaches used, type of specimens and etc.

    “This variation in S. pneumoniae frequency may be because of the performance of pneumococcal vaccination programme in some countries, patients’ age, diagnostic approaches used, type of specimens and etc.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Rapid detection of bacterial meningitis and appropriate antimicrobial therapy are critical to minimize neurological sequelae such as hearing loss, mental retardation, seizures and behavioural changes.

    “Rapid detection of bacterial meningitis and appropriate antimicrobial therapy are critical to minimize neurological sequelae such as hearing loss, mental retardation, seizures and behavioural changes [5].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] Sadighian, 2009, Molecular detection of common bacterial pathogens causing meningitis, Iranian J Publ Health

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Detection of small amounts of pathogen DNA from non-viable bacteria could potentially facilitate diagnosis in culture-negative cases.

    “This assay acts independently of bacterial growth, and detection of small amounts of pathogen DNA from non-viable bacteria could potentially facilitate diagnosis in culture-negative cases [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Schiess, 2021, The Impact and burden of neurological sequelae following bacterial meningitis: a narrative review, Microorganisms source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The finding of L. monocytogenes isolation is in agreement with previous reports on the isolation of L. monocytogenes in Iran.

    “This finding is in agreement with the previous reports on the isolation of L. monocytogenes in Iran [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Pournajaf, 2016, Prevalence and virulence determination of Listeria monocytogenes strains isolated from clinical and non-clinical samples by multiplex polymerase chain reaction, Rev Soc Bras Med Trop source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In many countries, especially in Sub-Saharan Africa and Asia, S. agalactiae is an important cause of bacterial meningitis in the neonates.

    “In many countries, especially in Sub-Saharan Africa and Asia, S. agalactiae is an important cause of bacterial meningitis in the neonates [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Nhantumbo, 2015, Frequency of pathogenic paediatric bacterial meningitis in Mozambique: the critical role of multiplex real-time polymerase chain reaction to estimate the burden of disease, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In many countries, S. agalactiae is a predominant agent of neonatal meningitis with high morbidity and mortality.

    “In many countries, S. agalactiae is a predominant agent of neonatal meningitis with high morbidity and mortality [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Nhantumbo, 2015, Frequency of pathogenic paediatric bacterial meningitis in Mozambique: the critical role of multiplex real-time polymerase chain reaction to estimate the burden of disease, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    L. monocytogenes is the third most common cause of bacterial meningitis in immunocompromised patients, elderly individuals and accounts for approximately 20% of neonate's meningitis.

    “L. monocytogenes is the third most common cause of bacterial meningitis in immunocompromised patients, elderly individuals and accounts for approximately 20% of neonate's meningitis [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Abdinia, 2014, Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children: a 10-year referral hospital-based study in Northwest Iran, Iran Red Crescent Med J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A report from Turkey showed that N. meningitidis serogroup W135 was the dominant bacterial agent of meningitis in children.

    “In accordance with our finding, a report from Turkey showed that N. meningitidis serogroup W135 was the dominant bacterial agent of meningitis in children [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Ceyhan, 2008, A prospective study of etiology of childhood acute bacterial meningitis, Turkey, Emerg Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In previous reports of Iran, Hib (15%) was the second most common causative agent of bacterial meningitis.

    “In previous reports of Iran, Hib (15%) was the second most common causative agent of bacterial meningitis [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Houri, 2017, Acute bacterial meningitis in Iran: systematic review and meta-analysis, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Based on the CDC reports in 2004, the rate of Hib meningitis was <15 per 100,000 in Iran.

    “Based on the CDC reports in 2004, the rate of Hib meningitis was <15 per 100,000 in Iran [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Feikin, 2004, Rapid assessment tool for Haemophilus influenzae type b disease in developing countries, Emerg Infect Dis source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Molecular typing of H. influenza was not performed, and for this reason, we were not able to discriminate type b and non-type b strains of H. influenzae.

    “However, molecular typing of H. influenza was not performed, and for this reason, we were not able to discriminate type b and non–type b strains of H. influenzae.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The prevalence of meningococcal meningitis in Iran was reported with lower frequency and accounts for 13% of all cases.

    “However, the prevalence of meningococcal meningitis in Iran was reported with lower frequency and accounts for 13% of all cases [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Houri, 2017, Acute bacterial meningitis in Iran: systematic review and meta-analysis, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In previous reports from Iran, Enterobacteriaceae was a common etiological agent of acute bacterial meningitis.

    “In previous reports from Iran, Enterobacteriaceae was a common etiological agent of acute bacterial meningitis [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Ghotaslou, 2015, Etiology of acute bacterial meningitis in Iran: a systematic review, Acta Med Iranica

      Not checked in the free run.

33 of 33

  • The paper relies on this without support.

    Most studies have mainly focused on single meningitis causative agent and specific geographic area, while a well nationwide surveillance system was not established.

    “Most studies have mainly focused on single meningitis causative agent and specific geographic area, while a well nationwide surveillance system was not established.”

  • The paper relies on this without support.

    CSF culture is only positive in 70–85% of patients who have not received antimicrobial therapy before lumbar puncture.

    “Cerebrospinal fluid (CSF) culture is considered as a diagnostic gold standard for acute bacterial meningitis, yet is only positive in 70–85% of patients who have not received antimicrobial therapy before lumbar puncture.”

  • The paper relies on this without support.

    Final results of the culture are often not available for ≥48 h.

    “Final results of the culture are often not available for ≥48 h.”

  • The paper relies on this without support.

    The positive rate of CSF culture is relatively low because of suboptimal storage and transportation conditions and culture practice.

    “Furthermore, the positive rate of CSF culture is relatively low because of suboptimal storage and transportation conditions and culture practice.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The reported sensitivity of PCR for pneumococcal meningitis is high and reached 100% in the majority of studies, with a median of 100% and range 79%-100%.

    “The reported sensitivity of PCR for pneumococcal meningitis is high and reached 100% in the majority of conducted studies (median of 100%, range 79%–100%) (Table 1; see also Table S1 in the supplemental material) (49–58).”

    From Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections (2024) · cites this paper as [57]

    The Discussion describes PCR assays as generally highly sensitive, and the Results (Tables 3–4) report 19 pneumococcal PCR-positive samples versus 18 culture-positive samples. The paper does not report that sensitivity reached 100% in most studies or give the claimed median of 100% and range of 79%–100%. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported median age conflicts with age distribution

    Major

    If 52% of the 100 patients were aged <1 year, the median age must also be <1 year; it cannot be 10.8 years.

1 of 1

Cites

Flagged first, then by citations

2 of the 28 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Yousefi Mashouf, 2014, Study of bacterial agents of meningitis in children and detection of their antibiotic resistance patterns in Hamadan, Western Iran, Int J Med Invest, 3, 18
  2. Boada, 2012, Bioinformatic analysis of virulence regulator PrfA and antimicrobial resistance of Listeria monocytogenes isolated from artisan cheeses in Cundinamarca Angélica, Revista Alimentos Hoy, 21, 115

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Authors
Zeighami, H., Roudashti, S., Bahari, S., Haghi, F., & Hesami, N.
Affiliations
  • Zanjan University of Medical Sciences (IR)
  • Islamic Azad University of Zanjan (IR)
Corresponding author
Haghi, F.
ORCID
Venue
New Microbes and New Infections
Publisher
Elsevier BV
Published
2021-09
Volume
43
Pages
100930
ISSN
2052-2975 (ISSN-L)
DOI
10.1016/j.nmni.2021.100930
PMC
PMC8414167
OpenAlex
W3195927794
Semantic Scholar
9d40d3a5d45df5be1c42c5c5befd7b5088494cec
Cited by
13
References
28
Citations by year
2025: 6 · 2024: 2 · 2023: 4 · 2022: 1
FWCI
1.24
Type
journal article
Language
en
Open access
Licence
Locations
  • New Microbes and New Infections (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Zanjan University of Medical Sciences (ZUMS.REC.1393.209)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
Keywords
bacterial meningitis, etiological agents, cerebrospinal fluid culture, PCR detection, Streptococcus pneumoniae, Neisseria meningitidis, Streptococcus agalactiae, Escherichia coli, Haemophilus influenzae, Listeria monocytogenes, pediatric meningitis

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