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Clinical Impact of Cerebrospinal Fluid Multiplex Polymerase Chain Reaction (PCR) Testing in Children with Suspected

Aytac Goktug1, Idil Ak Gundogdu2, Muhterem Duyu3

  • 1Istanbul Medeniyet University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine, Istanbul, Türkiye.

Medeniyet Medical Journal
|September 29, 2025
PubMed

Insights

Multiplex PCR testing for central nervous system (CNS) infections in children significantly impacts clinical decisions. Results helped discontinue unnecessary treatments, improving patient management and potentially reducing costs.

Area of Science:

  • Pediatric Infectious Diseases
  • Molecular Diagnostics
  • Clinical Microbiology

Background:

  • Central nervous system (CNS) infections are a major cause of childhood morbidity and mortality.
  • Accurate and timely diagnosis is crucial for effective management and improved patient outcomes.

Purpose of the Study:

  • To assess the impact of cerebrospinal fluid (CSF) multiplex polymerase chain reaction (PCR) panel results on clinical decision-making in pediatric meningitis/meningoencephalitis cases.
  • To evaluate how PCR findings influence treatment adjustments and patient management.

Main Methods:

  • Retrospective evaluation of 144 pediatric patients (1 month to 18 years) diagnosed with suspected CNS infections between 2018 and 2023.
  • Analysis of demographics, clinical presentation, CSF multiplex PCR results, and treatment modifications.
  • Exclusion of patients younger than 1 month, older than 18 years, those with non-infectious indications for lumbar puncture, and those with ventriculoperitoneal shunts.

Main Results:

  • Multiplex PCR detected at least one pathogen in 24.3% of patients (35/144).
  • Viral agents were most common (22/35), followed by bacterial agents (11/35).
  • Treatment was modified in 35.4% of patients (51/144) based on PCR results, primarily by discontinuing unnecessary antiviral or antibiotic therapy.

Conclusions:

  • Multiplex PCR testing is valuable for guiding clinical management in pediatric CNS infections.
  • PCR results facilitate the discontinuation of unnecessary treatments, potentially reducing costs and complications.
  • Early pathogen detection via PCR can optimize treatment strategies, especially in patients with prior antibiotic exposure.
Abstract

Keywords:
Central nervous system infectionscerebrospinal fluidpolymerase chain reaction (PCR)

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