Abstract

Objective: Central nervous system (CNS) infections are a significant cause of mortality and morbidity all over the world. Currently, molecular methods with high sensitivity and specificity provide a diagnosis from a small amount of cerebrospinal fluid (CSF) sample in a short time. Our study aims to determine whether the meningitis/encephalitis panel test is used rationally and to make appropriate recommendations for practical use in the approach to CNS infections.

Methods: Between January 2022 and 2023, 46 samples with meningitis/encephalitis panel requests were included in the study. Cerebrospinal fluid samples of the patients were studied with the QIAstat-Dx Analyzer (Qiagen, Hilden, Germany )and the QIAstat-Dx® Meningitis/Encephalitis (ME) Panel kiti (Qiagen, Hilden, Germany). Data about age, gender, CSF leukocyte, erythrocyte, glucose and protein, blood leukocytes and C-reactive protein (CRP) values, presence of fever, headache, neck stiffness, and altered consciousness in patients were obtained retrospectively from patient files and the hospital information system.

Results: Of the 46 patients, 22 were female and 24 were male. Three Varicella-zoster virus, two Herpes simplex virus-1, two Cryptococcus neoformans/gatti, one Escherichia coli K1 and one Listeria monocytogenes positivity were detected in the ME panel of a total of nine samples, five from female and four male patients; the total positivity rate was 19.5%. CSF leukocyte and erythrocyte value, blurred consciousness, blood leukocyte count, and CRP values did not differ significantly between panel (-) and panel (+) groups. Fever, headache, nuchal rigidity, high CSF protein, and low CSF glucose were very different in the group with panel (+) (p<0.05).

Conclusion: Requesting an ME panel with a rational algorithm after microbiological and biochemical evaluation of CSF samples taken with a strong clinical suspicion will be convenient and cost-effective, prevent unnecessary antibiotic or antiviral use, and reduce hospital stays.