Gabrielli Liliana, Tomaiuolo Miriam, Banchini Isabella, Balboni Alice, Liberatore Andrea, Lanna Federica, Cantiani Alessia, Bertoldi Alessia, Pavoni Matteo, Manzoli Lamberto, Lazzarotto Tiziana
Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Microbiology, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Microorganisms. 2025 Apr 13;13(4):892. doi: 10.3390/microorganisms13040892.
Acute central nervous system (CNS) infections, such as meningitis and encephalitis, represent medical emergencies that require rapid identification of the causative pathogen to guide appropriate therapeutic interventions. The QIAstat-Dx Meningitis/Encephalitis (QIA/ME) is a molecular syndromic panel that enables the simultaneous detection of multiple pathogens and provides the visualization of cycle threshold (Ct) values, offering rapid results for prompt clinical management. This study retrospectively tested, with the QIA/ME panel, 170 cerebrospinal fluid (CSF) samples from patients with CNS infections, confirmed through routine diagnostic workflows. The results were compared with those obtained from bacterial culture and singleplex PCR for viral detection. The QIA/ME demonstrated 100% concordance with reference methods for bacterial and yeast infections. For viral infections, the overall detection rate was 85.9%. Specifically, when singleplex PCR results exceeded 250 copies/mL for DNA viruses and 500 copies/mL for the RNA virus, the concordance rate with the QIA/ME was 96.8%. In contrast, when PCR values were below these thresholds, the concordance rate dropped to 43.8%. A strong overall correlation was observed between the viral load measured by singleplex PCR and Ct values from the QIA/ME (ρ = -0.83, < 0.001). Only for enterovirus a weak correlation was found (ρ = -0.40, = 0.056). The QIA/ME panel is an effective diagnostic tool for viral CNS infections, allowing for the visualization of Ct values that reflect pathogen load in samples and which could be useful in guiding clinical decision-making and patient management.
急性中枢神经系统（CNS）感染，如脑膜炎和脑炎，是需要迅速识别致病病原体以指导适当治疗干预的医疗急症。QIAstat-Dx脑膜炎/脑炎检测（QIA/ME）是一种分子症候群检测试剂盒，能够同时检测多种病原体，并提供循环阈值（Ct）值的可视化结果，为及时的临床管理提供快速检测结果。本研究使用QIA/ME试剂盒对170例中枢神经系统感染患者的脑脊液（CSF）样本进行回顾性检测，这些样本通过常规诊断流程得以确诊。将结果与细菌培养和用于病毒检测的单重PCR结果进行比较。QIA/ME试剂盒在细菌和酵母菌感染方面与参考方法的一致性达100%。对于病毒感染，总体检测率为85.9%。具体而言，当DNA病毒的单重PCR结果超过250拷贝/毫升、RNA病毒超过500拷贝/毫升时，与QIA/ME试剂盒的一致性率为96.8%。相比之下，当PCR值低于这些阈值时，一致性率降至43.8%。单重PCR检测的病毒载量与QIA/ME试剂盒的Ct值之间存在很强的总体相关性（ρ = -0.83，< 0.001）。仅肠道病毒的相关性较弱（ρ = -0.40， = 0.056）。QIA/ME试剂盒是诊断病毒性中枢神经系统感染的有效工具，能够可视化反映样本中病原体载量的Ct值，这有助于指导临床决策和患者管理。
