Volume 9, Issue 3 (2023)                   IEM 2023, 9(3): 219-228 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ghafari S, Namakin K, khooban A R, askari P, Yousefi M, Ziaee M. Comparison of Multiplex Quantitative Real-Time PCR and Culture Methods for the Diagnosis of Bacterial Meningitis in Patients with Suspected Meningitis. IEM 2023; 9 (3) :219-228
URL: http://iem.modares.ac.ir/article-4-71306-en.html
1- Cellular and Molecular Research Center, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran. Department of Microbiology and Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2- Cardiovascular Diseases Research Center, Department of Pediatrics, Birjand University of Medical Sciences, Birjand, Iran Birjand University of Medical Sciences, Birjand, Iran
3- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
4- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran , formaluse1368@gmail.com
Abstract:   (337 Views)
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 166 patients with suspected meningitis, who were treated in Vali-Asr hospital in Birjand, Iran between 2011 and 2020. Diagnosis of bacterial meningitis was based on CSF culture and multiplex qPCR results.
Findings: Among 166 patients, conventional methods identified causative pathogens in only 10.3% of cases, while multiplex qPCR detected pathogens in eight out of 25 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.
Full-Text [PDF 471 kb]   (129 Downloads)    
Article Type: Original Research | Subject: Bacteriology
Received: 2023/08/29 | Accepted: 2023/10/18 | Published: 2023/10/18

1. 1. Berangi Z, Karami M, Mohammadi Y, Nazarzadeh M, Zahraei SM, Javidrad H, et al. Epidemiological profile of meningitis in Iran before pentavalent vaccine introduction. BMC pediatrics. 2019;19:1-9. [DOI:10.1186/s12887-019-1741-y] [PMID] []
2. Başpınar EÖ, Dayan S, Bekçibaşı M, Tekin R, Ayaz C, Deveci Ö, et al. Comparison of culture and PCR methods in the diagnosis of bacterial meningitis. Brazilian journal of microbiology. 2017;48:232-6. [DOI:10.1016/j.bjm.2016.06.014] [PMID] []
3. Meiring S, Cohen C, De Gouveia L, Du Plessis M, Quan V, Kleynhans J, et al. Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020. International Journal of Infectious Diseases. 2022;122:1056-66. [DOI:10.1016/j.ijid.2022.07.068] [PMID]
4. de Filippis I, Andrade CFd, Caldeira N, Azevedo ACd, Almeida AEd. Comparison of PCR-based methods for the simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in clinical samples. Brazilian Journal of Infectious Diseases. 2016;20:335-41. [DOI:10.1016/j.bjid.2016.04.005] [PMID] []
5. Pallerla SR, Van Dong D, Linh LTK, Van Son T, Quyen DT, Hoan PQ, et al. Diagnosis of pathogens causing bacterial meningitis using Nanopore sequencing in a resource-limited setting. Annals of Clinical Microbiology and Antimicrobials. 2022;21(1):1-8. [DOI:10.1186/s12941-022-00530-6] [PMID] []
6. Saravolatz LD, Manzor O, VanderVelde N, Pawlak J, Belian B. Broad-range bacterial polymerase chain reaction for early detection of bacterial meningitis. Clinical infectious diseases. 2003;36(1):40-5. [DOI:10.1086/345438] [PMID]
7. Seth R, Murthy PSR, Sistla S, Subramanian M, Tamilarasu K. Rapid and accurate diagnosis of acute pyogenic meningitis due to Streptococcus pneumoniae, Haemophilus influenzae Type b and Neisseria meningitidis using a multiplex PCR assay. Journal of Clinical and Diagnostic Research: JCDR. 2017;11(9):FC01. [DOI:10.7860/JCDR/2017/28114.10532] [PMID] []
8. Shrestha RG, Tandukar S, Ansari S, Subedi A, Shrestha A, Poudel R, et al. Bacterial meningitis in children under 15 years of age in Nepal. BMC pediatrics. 2015;15(1):1-7. [DOI:10.1186/s12887-015-0416-6] [PMID] []
9. Welinder-Olsson C, Dotevall L, Hogevik H, Jungnelius R, Trollfors B, Wahl M, et al. Comparison of broad-range bacterial PCR and culture of cerebrospinal fluid for diagnosis of community-acquired bacterial meningitis. Clinical microbiology and infection. 2007;13(9):879-86. [DOI:10.1111/j.1469-0691.2007.01756.x] [PMID]
10. Abdinia B, Rezaee MA, Oskouie SA. Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children: a 10-year referral hospital-based study in northwest iran. Iranian Red Crescent Medical Journal. 2014;16(7). [DOI:10.5812/ircmj.17616] [PMID] []
11. Samuelson F, Abbey C. Using relative statistics and approximate disease prevalence to compare screening tests. The international journal of biostatistics. 2016;12(2):20160017. [DOI:10.1515/ijb-2016-0017] [PMID] []
12. Pouladfar G, Dashti AS, Kadivar MR, Jafari M, Pourabbas B, Jamalidoust M, et al. Evaluation of Multiplex Real-time PCR and WHO Criteria for Diagnosing Childhood Bacterial Meningitis in a Tertiary Referral Hospital in Iran. Archives of Pediatric Infectious Diseases. 2022;10(3). [DOI:10.5812/pedinfect.101822]
13. Sasan MS, Alborzi A, Ziyaeyan M. Epidemiology of aseptic meningitis in infants and children (shiraz-Iran). Archives of Clinical Infectious Diseases. 2012;7(4):116-8. [DOI:10.5812/archcid.15086]
14. Borjian S. The common agents of bacterial Meningitis in children in Borujen. Journal of Shahrekord University of Medical Sciences. 1999;1(2):52-8.
15. Kanani S, Moradi G. Epidemiological survey of acute meningitis in Kurdistan province from 1381 to the end of 1383. Scientific Journal of Kurdistan University of Medical Sciences. 2005;10(2):49-54.
16. Ghuneim N, Dheir M, AbuAli K. Epidemiology of Different Types of Meningitis Cases in Gaza Governorates, Occupied Palestinian Territory, December 2013-January 2014. J Antivir Antiretrovir. 2016;8(1):26-34. [DOI:10.4172/jaa.1000132]
17. Pérez AE, Dickinson FO, Rodríguez M. Community acquired bacterial meningitis in Cuba: a follow up of a decade. BMC Infectious Diseases. 2010;10(1):1-9. [DOI:10.1186/1471-2334-10-130] [PMID] []
18. Coutlee F, Viscidi R, Saint-Antoine P, Kessous A, Yolken R. The polymerase chain reaction: a new tool for the understanding and diagnosis of HIV-1 infection at the molecular level. Molecular and cellular probes. 1991;5(4):241-59. [DOI:10.1016/0890-8508(91)90046-M] [PMID]
19. Thiele D. The technique of polymerase chain reaction-a new diagnostic tool in microbiology and other scientific fields. Zentralblatt für Bakteriologie. 1990;273(4):431-54. [DOI:10.1016/S0934-8840(11)80451-2] [PMID]
20. Bahador M, Amini M, Bahador M. Common cause and cerebrospinal fluid changes of acute bacterial meningitis. 2009.
21. Kastenbauer S, Pfister HW. Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. Brain. 2003;126(5):1015-25. [DOI:10.1093/brain/awg113] [PMID]
22. Theodoridou MN, Vasilopoulou VA, Atsali EE, Pangalis AM, Mostrou GJ, Syriopoulou VP, et al. Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period. BMC Infectious Diseases. 2007;7:1-12. [DOI:10.1186/1471-2334-7-101] [PMID] []
23. Heydari B, Khalili H, Karimzadeh I, Emadi-Kochak H. Clinical, paraclinical, and antimicrobial resistance features of community-acquired acute bacterial meningitis at a large infectious diseases ward in Tehran, Iran. Iranian Journal of Pharmaceutical Research: IJPR. 2016;15(1):347.
24. Collins S, Vickers A, Ladhani SN, Flynn S, Platt S, Ramsay ME, et al. Clinical and molecular epidemiology of childhood invasive nontypeable Haemophilus influenzae disease in England and Wales. The pediatric infectious disease journal. 2016;35(3):e76-e84. [DOI:10.1097/INF.0000000000000996] [PMID]
25. Ramalingam RKTC, Chakraborty D. Retrospective analysis of multiplex polymerase chain reaction-based molecular diagnostics (SES) in 70 patients with suspected central nervous system infections: A single-center study. Annals of Indian Academy of Neurology. 2016;19(4):482. [DOI:10.4103/0972-2327.192483] [PMID] []
26. Mado SM, Aliyu I. Acute bacterial meningitis in nigerian children beyond neonatal period: A review. Nigerian Journal of Basic and Clinical Sciences. 2018;15(1):1. [DOI:10.4103/njbcs.njbcs_26_17]
27. Hosseininasab A, Alborzi A, Ziyaeyan M, Jamalidoust M, Moeini M, Pouladfar G, et al. Viral etiology of aseptic meningitis among children in southern Iran. Journal of medical virology. 2011;83(5):884-8. [DOI:10.1002/jmv.22056] [PMID]
28. Vincent J-J, Zandotti C, Baron S, Kandil C, Levy P-Y, Drancourt M, et al. Point-of-care multiplexed diagnosis of meningitis using the FilmArray® ME panel technology. European Journal of Clinical Microbiology & Infectious Diseases. 2020;39:1573-80. [DOI:10.1007/s10096-020-03859-y] [PMID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.