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Cerebrospinal fluid multiplex PCR cycle thresholds may predict ICU admission in community-acquired

Pilar Vizcarra1, David Grandioso Vas1, María Inmaculada Quiles Melero1

  • 1Department of Clinical Microbiology and Parasitology, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.

Diagnostic Microbiology and Infectious Disease
|February 1, 2025
PubMed
Abstract

Insights

Lower cerebrospinal fluid (CSF) PCR cycle threshold (Ct) values in suspected meningitis correlate with increased ICU admissions. QIAstat-Dx® ME Panel shows high concordance with standard methods for diagnosing meningitis.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Central nervous system infections, including meningitis, require rapid and accurate diagnosis.
  • Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) cycle threshold (Ct) values may offer prognostic information.
  • The QIAstat-Dx® ME Panel is a multiplex assay for detecting common pathogens in CSF.

Purpose of the Study:

  • To investigate the association between CSF PCR Ct values and clinical characteristics in suspected meningitis.
  • To assess the predictive value of Ct values for intensive care unit (ICU) admission and mortality.
  • To evaluate the concordance of the QIAstat-Dx® ME Panel with established diagnostic methods.

Main Methods:

  • Analysis of frozen CSF samples from 30 individuals with suspected meningitis using the QIAstat-Dx® ME Panel.
  • Categorization of Ct values as low (≤30) or high (>30).
  • Assessment of concordance with CSF FilmArray®/culture using the Kappa coefficient.

Main Results:

  • Low Ct values were linked to CSF markers of meningitis and predicted ICU admissions (P = 0.025).
  • Individuals with low Ct values had higher ICU admission rates within the first two weeks (85% vs. 50%, P = 0.041).
  • The QIAstat-Dx® ME Panel demonstrated substantial agreement with comparator methods (Kappa = 0.839).

Conclusions:

  • CSF PCR Ct values can aid in risk stratification for timely ICU admission in meningitis patients.
  • The QIAstat-Dx® ME Panel is a reliable diagnostic tool for suspected meningitis.
Keywords:
Community acquired meningoencephalitisCycle thresholdsIntensive carePolymerase chain reaction

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