Work

Diagnostic role of multiplex polymerase chain reaction compared to conventional cerebrospinal fluid analysis in pediatric meningitis/meningoencephalitis at tertiary care center in low- and middle-income country

Year: 2026

Type: article

Abstract: Background: Meningitis/ meningoencephalitis (M/E) in children is a medical emergency that can have fatal outcomes. Early and accurate diagnosis is usually hindered by the shortcomings of conventional cerebrospinal fluid (CSF) tests, which remains the primary diagnostic modality in low- and middle- income country settings (LMIC), and results are frequently affected by prior antibiotic exposure. This study evaluates the potential use of multiplex Polymerase Chain Reaction (PCR), a rapid molecular technique, to enhance the detection of pathogens in CSF, facilitating rapid and more accurate diagnosis and treatment. Aims and Objectives: Compare the diagnostic utility of multiplex PCR to conventional CSF tests in diagnosis of meningitis/meningoencephalitis in children and to determine pathogen detection rate using this method. Materials and Methods: Hospital based cross-sectional observational study was carried out in tertiary care centre of Western Uttar Pradesh. Fifty children aged 6 months to 18 years presenting with clinical features of M/E were included. CSF samples were analyzed using cytology, biochemistry, Gram stain, culture, and multiplex PCR targeting common pathogens. Results: Majority of Patient were < 1 year (15, 30% ), with male preponderance (male: female-1.5:1). Multiplex PCR detected pathogens in 7 cases (14%)—3 ( 6%) bacterial and 4 ( 8%) viral , out of which 2 cases of bacterial meningitis and 1 case of viral meningitis had already received antibiotics and antiviral respectively. Conventional methods (Gram stain and culture) did not identify any pathogen. PCR-positive cases showed higher leukocyte counts (p = 0.054) and lower CSF glucose (p=0.026) and higher protein level (p=0.408 , not significant ). Conclusion: Multiplex PCR outperformed conventional tests in identifying causative organisms in pediatric meningitis, including cases already treated with antibiotics and antiviral. Its rapid and accurate results can guide timely, targeted treatment potentially reducing complications and mortality.

Source: Asian Journal of Medical Sciences

DOI: 10.71152/ajms.v17i9.5441

Authors: Deepty Nauriyal, Sukhjinder Singh, Anterpreet Kaur, Deepak Kumar, Ajay Punj

Institution: Subharti Medical College

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $200