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Improved Diagnostics in Bacterial Neonatal Meningitis Using a Next-Generation Sequencing Platform

Alieke van der Hoeven1, Martha T van der Beek2, Vincent Bekker3

  • 1Department of Medical Microbiology, Leiden University Medical Center, Postzone E4-P, Postbus 9600, 2300 RC, Leiden, The Netherlands. A.vanderHoeven@LUMC.nl.

Infectious Diseases and Therapy
|July 12, 2023
PubMed
Abstract

Insights

Next-generation sequencing (NGS) of the 16S rRNA gene significantly enhances bacterial pathogen detection in infant meningitis cases compared to traditional cerebrospinal fluid (CSF) cultures. This advanced molecular method improves diagnostic accuracy for this critical condition.

Area of Science:

  • Medical Microbiology
  • Neonatal Infectious Diseases
  • Molecular Diagnostics

Background:

  • Bacterial meningitis in infants is a severe, life-threatening condition requiring prompt empiric treatment.
  • Conventional cerebrospinal fluid (CSF) cultures have limitations in detecting bacterial pathogens due to antibiotic influence.
  • Nucleic acid amplification tests (NAATs) like PCR require prior knowledge of potential pathogens.

Purpose of the Study:

  • To evaluate the diagnostic utility of a culture-free, broad-range 16S rRNA gene next-generation sequencing (NGS) platform (MYcrobiota) for bacterial meningitis in infants.
  • To compare the bacterial pathogen detection rate of MYcrobiota with conventional bacterial culture methods.

Main Methods:

  • Retrospective cohort study conducted in a level III neonatal intensive care unit.
  • Analysis of 37 CSF samples from 35 infants with suspected meningitis between November 2017 and December 2020.
  • Comparison of bacterial pathogen detection rates between MYcrobiota (16S rRNA gene NGS) and conventional bacterial culture.

Main Results:

  • MYcrobiota detected bacterial pathogens in 11 out of 37 (30%) CSF samples.
  • Conventional CSF culture identified bacteria in only 2 out of 36 (5.6%) samples.
  • NGS demonstrated a substantially higher detection rate for bacterial pathogens.

Conclusions:

  • The addition of 16S rRNA gene sequencing significantly improved the identification of bacterial meningitis etiology.
  • Culture-free NGS offers a valuable advancement over conventional CSF culturing for diagnosing bacterial meningitis in neonates.
Keywords:
Bacterial meningitisDiagnosisNeonatal meningitisNext-generation sequencing

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