Molecular Diagnostics in CSF: Comprehensive Review of PCR Methods for CNS Infections
This review in Clinical Microbiology Reviews evaluates nucleic acid amplification methods for detecting bacteria, viruses, fungi, and parasites in cerebrospinal fluid, including single-target PCR, multiplex panels, and broad-range bacterial/fungal PCR with sequencing. Despite significant advances, a substantial proportion of CNS infections remain pathogen-negative. The paper assesses innovative molecular approaches that may close this diagnostic gap.
The original study
Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections.
- Authors
- Olie SE, Andersen CØ, van de Beek D, Brouwer MC
- Journal
- Clinical microbiology reviews
- Type
- Journal Article, Review
- PMID
- 39404267
Original 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.