Examination of cerebrospinal fluid samples of patients with a pre-diagnosed central nervous system infection by conventional and molecular methods

Meningitis, an infection of the central nervous system, is caused by inflammation of the membranes of the brain caused by various microorganisms. Since the clinical picture of meningitis can progress rapidly, leading to death or serious permanent sequelae, early and rapid diagnosis is very important in meningitis. Currently, specific methods such as culture of Cerebrospinal Fluid (CSF) and Polymerase Chain Reaction (PCR) are used to confirm the presence of meningitis. In this study, 90 CSF samples sent to Bolu Abant İzzet Baysal University Training and Research Hospital Microbiology Laboratory with a preliminary diagnosis of central nervous system infection were analyzed by conventional (culture, etc.) and molecular methods (multiplex PCR) to detect bacterial and viral agents. Of the 90 CSF samples, 10 showed growth in culture, while bacterial and viral agents were detected by PCR in seven. Acinetobacter Baumannii was detected in one culture, Nocardia spp in one, Methicillin Sensitive Coagulase Negative Staphylacocci (MSCNS) in three, Methicillin Resistant Coagulase Negative Staphylacocci (MRCNS) in three and Methicillin Resistant Staphylacoccus aureus (MRSA) in the remaining two. Of the seven PCR positive samples, S. pneumoniae DNA was detected in three, HSV-1 DNA in three and VZV DNA in one. Culture is the gold standard for the diagnosis and typing of bacterial meningitis. Today, PCR method has become more preferred because it provides fast and reliable results in the detection of meningitis-causing microorganisms such as bacteria and viruses that cannot be detected by culture method. However, PCR is a diagnostic method that can detect the desired agent if there is a primer for the desired agent, otherwise the desired agent cannot be found. Therefore, we believe that PCR and culture methods should be evaluated together with the clinical condition of the patient.