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Cited by 1Infectious Encephalopathies and EncephalitisViral Infections and Immunology ResearchBacterial Infections and Vaccines

Santral Sinir Sistemi Enfeksiyonlarının Hızlı Tanısında Multipleks PCR İncelemesinin Rolü ve Çocuklarda Viral Etiyoloji

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Ayhan, Fahri Yüce, Apa, Hurşit, Akaslan Kara, Aybüke, Yılmaz Çelebi, Miray, Kaçar, Pelin, Gülnar, Nilüfer, Devrim, İlker·2024·Mikrobiyoloji Bulteni
DOI 10.5578/mb.20249618
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Abstract

Central nervous system infections (CNS) are life-threatening infections in children, requiring urgent intervention and rapid diagnosis. In this study, we aimed to investigate the efficacy of syndromic tests in diagnosing CNS infections and the distribution of viral pathogens in pediatric patients. A total of 145 pediatric patients with a prediagnosis of CNS infection based on clinical findings by a pediatric infectious disease specialist were included in the study. Microscopic examination, biochemical tests, bacteriologic culture, and syndromic test (BioFire® FilmArray® Meningitis/Encephalitis Panel) were performed on cerebrospinal fluid samples obtained from the patients. Nearly half (44.8%) of the patients were younger than one year of age, the median age was 12 months (6-60 months), and the male-to-female ratio was 1.7, with 92 male and 53 female patients. Viral pathogens were observed in most of the 29 (18.8%) patients with syndromic test positivity (n= 23, 79.4%), while bacterial pathogens were detected in 20.6% (n= 6). No fungal pathogens were detected. Bacterial pathogens were Streptococcus pneumoniae [3.4% (5/145)] and Neisseria meningitidis [0.7% (1/145)]. Viruses were enterovirus [6.9% (10/145)], human herpesvirus-6 [5.5% (8/145)], herpes simplex virus type 1 [1.4% (2/145)], cytomegalovirus [0.7% (1/145)], human parechovirus [0.7% (1/145)], varicella zoster virus [0.7% (1/145)]. The main finding in cases with positive syndromic test was fever (n= 19, 65.5%), followed by vomiting (n= 15, 51.7%), convulsion (n= 14, 48.3%) and rash (n= 6, 20.6%). For turnaround time the median was 111 minutes and the mean was 119 minutes. Despite the lack of a performance study including sensitivity and specificity for syndromic testing or alternative tests for viral etiology, our study demonstrates the benefits of syndromic testing in children with presumed CNS infections, such as shortening the diagnostic period and guiding empirical treatment. It also constitutes an affirmative example of laboratory and clinical collaboration.

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  • Published positivity rates for CSF multiplex PCR range from 18.8% to 32.8%.

    “Published positivity rates for CSF multiplex PCR range from 18.8% to 32.8%10, 11, 12, aligning with our positivity rate of 24.3%.”

    From Clinical Impact of Cerebrospinal Fluid Multiplex Polymerase Chain Reaction (PCR) Testing in Children with Suspected Central Nervous System Infection (2025) · cites this paper as [11]

    The Discussion (p. 4) reports 18.8% positivity in this study and cites another study reporting 32.8%, so both stated endpoints appear in the source. But it also reports published pediatric rates of 12.2% and 13.2%; thus 18.8%–32.8% is not the full range of published rates the paper discusses. (LLM, conf=0.86)

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Research works printed but not linked: 20

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Authors
Ayhan, F. Y., Apa, H., Akaslan Kara, A., Yılmaz Çelebi, M., Kaçar, P., Gülnar, N., & Devrim, İ.
Affiliations
Dr. Behçet Uz Çocuk Hastalıkları Hastanesi (TR)
ORCID
Venue
Mikrobiyoloji Bulteni
Publisher
Bilimsel Tip Publishing House
Published
2024-10-30
Volume
58
Issue
4
Pages
461-470
ISSN
0374-9096 (ISSN-L)
DOI
10.5578/mb.20249618
OpenAlex
W4403947731
Cited by
0
References
0
FWCI
0.00
Type
journal article
Language
tr
Open access
Locations
  • Mikrobiyoloji Bulteni (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
central nervous system infection, pediatric meningitis, encephalitis, multiplex PCR, syndromic testing, BioFire FilmArray, viral etiology, cerebrospinal fluid, enterovirus, human herpesvirus 6, herpes simplex virus type 1, cytomegalovirus, human parechovirus, Streptococcus pneumoniae, Neisseria meningitidis, rapid diagnosis, turnaround time
MeSH terms
Adolescent, Central Nervous System Infections, Child, Child, Preschool, Female, Humans, Infant, Male, Central Nervous System Viral Diseases, Multiplex Polymerase Chain Reaction

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