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Published on: November 29, 2019
Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections
Sabine E Olie1, Christian Ø Andersen2, Diederik van de Beek1
1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
Abstract:
SUMMARYCentral nervous system (CNS) infections can be caused by various pathogens, including bacteria, viruses, fungi, and parasites. Molecular diagnostic methods are pivotal for identifying the different causative pathogens of these infections in clinical settings. The efficacy and specificity of these methods can vary per pathogen involved, and in a substantial part of patients, no pathogen is identified in the cerebrospinal fluid (CSF). Over recent decades, various molecular methodologies have been developed and applied to patients with CNS infections. This review provides an overview of the accuracy of nucleic acid amplification methods in CSF for a diverse range of pathogens, examines the potential value of multiplex PCR panels, and explores the broad-range bacterial and fungal PCR/sequencing panels. In addition, it evaluates innovative molecular approaches to enhance the diagnosis of CNS infections.
Insights
Molecular diagnostics are key for identifying central nervous system (CNS) infections. This review assesses nucleic acid amplification methods, multiplex PCR, and novel approaches for improved pathogen detection in cerebrospinal fluid (CSF).
Area of Science:
- Neurology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Central nervous system (CNS) infections pose significant diagnostic challenges.
- Causative agents include bacteria, viruses, fungi, and parasites.
- Current diagnostic methods have limitations, with unidentified pathogens in many cases.
Purpose of the Study:
- To review the accuracy of molecular diagnostic methods for CNS infections.
- To evaluate the utility of multiplex PCR panels and broad-range PCR/sequencing.
- To explore innovative molecular techniques for enhanced diagnosis.
Main Methods:
- Review of nucleic acid amplification methods (NAATs) in cerebrospinal fluid (CSF).
- Assessment of multiplex PCR panels for pathogen identification.
- Exploration of broad-range bacterial and fungal PCR/sequencing.
- Evaluation of novel molecular diagnostic approaches.
Main Results:
- Nucleic acid amplification methods show varying efficacy and specificity depending on the pathogen.
- Multiplex PCR panels offer potential for simultaneous detection of multiple pathogens.
- Broad-range PCR and sequencing can identify a wider range of bacterial and fungal targets.
- Innovative molecular techniques aim to improve sensitivity and reduce turnaround time.
Conclusions:
- Molecular diagnostics are crucial for accurate and timely identification of CNS pathogens.
- Multiplex PCR and broad-range methods enhance diagnostic yield.
- Continued development of innovative molecular approaches is essential for improving CNS infection diagnosis.
