Evaluation of the accuracy of multiplex polymerase chain reaction in differentiation between bacterial and viral meningitis

Abstract

BackgroundMeningitis is one of the most dangerous infection affecting children. The need for rapid and accurate diagnosis is mandatory for improving the outcome.Aim of the workTo evaluate the role of multiplex polymerase chain reaction (PCR) in diagnosis of meningitis either bacterial or viral and to detect its accuracy.Patients and methodsA cross-sectional study was carried out in University Children Hospital, Faculty of Medicine, between November 2019 and September 2020. The study was approved by the Ethics Review Board of Faculty of Medicine, Assiut University, and informed written consent was obtained. The committee’s reference number is 17200161. Clinicaltrails.gov ID: NCT03387969. Forty-eight children aged 2 to 18 years with meningitis were included. Detailed history and examination, blood glucose level at time of admission prior to lumbar puncture, and multiplex PCR in cerebrospinal fluid (CSF) were evaluated.ResultsThe mean age of children was 3.27 ± 1.27 years. Thirty-five (72.9%) cases were bacterial meningitis while 13 (27.1%) cases were viral meningitis. Multiplex PCR had 94% sensitivity and 100% specificity for diagnosis of bacterial meningitis.ConclusionMultiplex PCR may help in diagnosis and differentiation of bacterial and viral meningitis with accurate and rapid results.What is Known:• Rapid and accurate diagnosis is mandatory for successful treatment of meningitis.• Differentiation between bacterial and viral meningitis is important to avoid unnecessary treatment..What is New:• Multiplex PCR is an important marker for rapid detection of meningitis.• Multiplex PCR may be used to differentiate between bacterial and non-bacterial cause of meningitis.