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Updated: Aug 13, 2026
Multiplex PCR and Reverse Line Blot Hybridization Assay mPCR/RLB
Published on: August 6, 2011
Use of multiplex PCR based molecular diagnostics in diagnosis of suspected CNS infections in tertiary care setting-A
Mahendra Javali1, Purushottam Acharya1, Aneesh Mehta1
1Dept. of Neurology, MS Ramaiah Memorial Hospital, India.
Objectives:
CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections.
Patients And Methods:
This study was conducted in our tertiary level Neurology ICU. 110 patients admitted during Nov-2010 to April-2014 were included. CSF samples of patients clinically suspected of having CNS infections were subjected to routine investigation in our laboratory and SES test at XCyton Diagnostics. We studied the impact of SES in diagnosis of CNS infections and its efficacy in helping therapeutic management.
Results:
SES showed detection rate of 42.18% and clinical specificity of 100%. It had 10 times higher detection rate than conventional tests. Streptococcus pneumoniae and Mycobacterium tuberculosis were two top bacterial pathogens. VZV was most detected viral pathogen. SES results elicited changes in therapy in both positive and negative cases. We observed superior patient outcomes as measured by GCS scale. 75% and 82.14% of the patients positive and negative on SES respectively, recovered fully.
Conclusion:
Detecting causative organism and ruling out infectious etiology remain the most critical aspect for management and prognosis of patients with suspected CNS infections. In this study, we observed higher detection rate of pathogens, target specific escalation and evidence based de-escalation of antimicrobials using SES. Institution of appropriate therapy helped reduce unnecessary use of antimicrobials.
Insights
A novel multiplex molecular diagnostic system (SES) significantly improved the detection of central nervous system (CNS) infections compared to conventional methods. This led to better therapeutic management and improved patient outcomes in a tertiary care setting.
Area of Science:
- Neurology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Central nervous system (CNS) infections present significant challenges due to high mortality and long-term sequelae.
- Traditional diagnostic methods in tertiary settings often lack specificity for identifying microbial etiology.
- Molecular diagnostics offer a promising solution to bridge this diagnostic gap.
Purpose of the Study:
- To evaluate the clinical impact and diagnostic efficacy of a commercial multiplex molecular diagnostic system, the Sample-based Evaluation System (SES).
- To assess the role of SES in guiding therapeutic management for suspected CNS infections.
Main Methods:
- A study involving 110 patients with suspected CNS infections admitted to a tertiary Neurology ICU between November 2010 and April 2014.
- Cerebrospinal fluid (CSF) samples were analyzed using routine investigations and the SES test.
- The impact of SES on diagnosis and therapeutic decisions was investigated.
Main Results:
- SES demonstrated a 42.18% detection rate and 100% clinical specificity, outperforming conventional tests by tenfold.
- Key pathogens identified included Streptococcus pneumoniae, Mycobacterium tuberculosis, and Varicella-zoster virus (VZV).
- SES results influenced therapy adjustments, leading to superior patient outcomes, with 75% of SES-positive and 82.14% of SES-negative patients achieving full recovery.
Conclusions:
- Accurate pathogen identification is crucial for managing and predicting the prognosis of CNS infections.
- SES facilitates higher pathogen detection rates, enabling targeted antimicrobial escalation and evidence-based de-escalation.
- The use of SES supports appropriate therapy, reducing unnecessary antimicrobial use and improving patient recovery.
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