Sharma Supriya, Acharya Jyoti, Caugant Dominique A, Banjara Megha Raj, Ghimire Prakash, Singh Anjana
Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu 44600, Nepal.
National Public Health Laboratory, Teku, Kathmandu 44600, Nepal.
Infect Dis Rep. 2021 Mar 1;13(1):173-180. doi: 10.3390/idr13010019.
The rapid identification of bacteria causing meningitis is crucial as delays in the treatment increase mortality rate. Though considered as the gold standard for the laboratory diagnosis of bacterial meningitis, culture might give false negative results in a case of patients under antibiotics prior to lumbar puncture. This study aimed to detect , and by a multiplex polymerase chain reaction (PCR) in culture-negative cerebrospinal fluid samples collected from clinically suspected meningitis cases attending different hospitals in Kathmandu, Nepal from January 2017 to December 2019. , and were detected in 8.59% (33/384) of the specimens by PCR and 7.55% (29/384) of the specimens by culture. Correlation between culture and PCR of the same sample was good (Spearman's rho correlation coefficient = 0.932). However, the difference in positivity between culture and PCR was statistically not significant ( value > 0.05). In four specimens, culture could not detect any of the targeted bacteria whereas PCR could detect presence of . PCR increases the diagnostic yield for bacterial meningitis. PCR may be considered as an adjunctive test for establishing the cause of infection in culture negative clinically suspected meningitis cases.
快速鉴定引起脑膜炎的细菌至关重要，因为治疗延迟会增加死亡率。虽然培养被认为是细菌性脑膜炎实验室诊断的金标准，但在腰椎穿刺前接受过抗生素治疗的患者中，培养可能会给出假阴性结果。本研究旨在通过多重聚合酶链反应（PCR）检测2017年1月至2019年12月期间从尼泊尔加德满都不同医院临床疑似脑膜炎病例采集的培养阴性脑脊液样本中的[具体细菌名称1]、[具体细菌名称2]和[具体细菌名称3]。通过PCR在8.59%（33/384）的标本中检测到了[具体细菌名称1]、[具体细菌名称2]和[具体细菌名称3]，通过培养在7.55%（29/384）的标本中检测到了这些细菌。同一样本的培养和PCR之间的相关性良好（斯皮尔曼等级相关系数=0.932）。然而，培养和PCR之间的阳性差异在统计学上不显著（P值>0.05）。在四个标本中，培养未检测到任何目标细菌，而PCR检测到了[具体细菌名称]的存在。PCR提高了细菌性脑膜炎的诊断率。PCR可被视为在培养阴性的临床疑似脑膜炎病例中确定感染原因的辅助检测方法。
