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Pathogen profiles in CSF from patients with acute infectious meningitis or encephalitis: a multicenter study based on

Changcheng Wu1, Xinlei Sun1, Wei Zhang2

  • 1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.

BMC Infectious Diseases
|November 25, 2025
PubMed

Insights

This study identified common pathogens causing acute meningitis or encephalitis (AME) in China using multiplex PCR and metagenomic sequencing. Combining both methods significantly improved pathogen detection rates for better AME diagnosis and treatment.

Area of Science:

  • * Infectious Diseases
  • * Neuroscience
  • * Microbiology

Background:

  • * Acute meningitis or encephalitis (AME) poses significant health risks, often leading to severe complications or death.
  • * Systematic research on the spectrum of pathogens causing AME in China is limited.
  • * Understanding the causative agents is crucial for effective diagnosis and treatment strategies.

Purpose of the Study:

  • * To comprehensively characterize the pathogen spectrum of AME in China.
  • * To evaluate the diagnostic efficacy of multiplex PCR (MPCR) and metagenomic next-generation sequencing (mNGS).
  • * To provide data supporting the development of drugs and vaccines for AME.

Main Methods:

  • * Cerebrospinal fluid (CSF) samples from 229 AME patients in China (2018-2019) were analyzed.
  • * Pathogen identification was performed using 43-pathogens multiplex PCR (MPCR).
  • * Metagenomic next-generation sequencing (mNGS) was applied to a subset of samples for comprehensive pathogen profiling.

Main Results:

  • * MPCR detected at least one pathogen in 31.88% of cases.
  • * mNGS confirmed all MPCR findings and identified additional pathogens in previously undiagnosed cases.
  • * Commonly detected viruses included Human herpesvirus (HHV), Adenovirus, Enterovirus/Rhinovirus (Ev/Rv); bacteria included Bordetella pertussis, Haemophilus influenzae, and Listeria monocytogenes.
  • * Enterovirus/Rhinovirus (Ev/Rv) were prevalent in adolescent cases, and tick-borne encephalitis was concentrated in northeastern China.

Conclusions:

  • * This study provides a systematic characterization of AME pathogens in China.
  • * The combination of MPCR and mNGS significantly enhances diagnostic rates for AME pathogens.
  • * Findings support improved diagnosis, treatment, and development of countermeasures for AME.
Keywords:
Acute meningitisCerebrospinal fluidEncephalitisMetagenomic next generation sequencingMultiplex PCR

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