de Almeida Sérgio Monteiro, Dalla Costa Libera Maria, Siebra Christian, Arend Lavinia Nery Villa Stangler, Nogueira Keite da Silva
Universidade Federal do Paraná, Complexo Hospital de Clínicas, Ambulatório de Neuroinfecção, Curitiba PR, Brasil.
Universidade Federal do Paraná, Complexo Hospital de Clínicas, Laboratório de Virologia, Curitiba PR, Brasil.
Arq Neuropsiquiatr. 2019 May 13;77(4):224-231. doi: 10.1590/0004-282X20190028.
This study evaluated the operational characteristics of the multiplex polymerase chain reaction (PCR) for cerebrospinal fluid (CSF) from patients with cellular and biochemical characteristics of acute bacterial meningitis and positive or negative CSF cultures.
Multiplex PCR was performed for 36 CSF samples: culture-proven acute bacterial meningitis (n = 7), culture-negative acute bacterial meningitis (n = 17), lymphocytic meningitis (n = 8), and normal CSF (n = 4). The operational characteristics of multiplex PCR were evaluated with definite and probable bacterial meningitis, using culture positive, cytological and biochemical CSF characteristics as the gold standard.
Multiplex PCR for CSF was efficient in the group with CSF cellular and biochemical characteristics of acute bacterial meningitis but with a negative CSF culture. This group demonstrated high specificity, positive predictive value, and efficiency.
Multiplex PCR for CSF can improve the speed and accuracy of acute bacterial meningitis diagnosis in a clinical setting as a complement to classical immunological and bacteriological assays in CSF. It is also useful for CSF culture-negative acute bacterial meningitis.
本研究评估了多重聚合酶链反应（PCR）对具有急性细菌性脑膜炎细胞和生化特征且脑脊液（CSF）培养阳性或阴性的患者脑脊液的操作特性。
对36份脑脊液样本进行多重PCR检测：培养证实的急性细菌性脑膜炎（n = 7）、培养阴性的急性细菌性脑膜炎（n = 17）、淋巴细胞性脑膜炎（n = 8）和正常脑脊液（n = 4）。以培养阳性、脑脊液细胞学和生化特征作为金标准，评估多重PCR在确诊和疑似细菌性脑膜炎中的操作特性。
脑脊液多重PCR对具有急性细菌性脑膜炎脑脊液细胞和生化特征但脑脊液培养阴性的组有效。该组显示出高特异性、阳性预测值和效率。
脑脊液多重PCR作为脑脊液中经典免疫学和细菌学检测的补充，可提高临床环境中急性细菌性脑膜炎诊断的速度和准确性。它对脑脊液培养阴性的急性细菌性脑膜炎也有用。
