Rational Use of Syndromic Molecular Testing in the Diagnosis of Meningitis/Encephalitis: A Two-Year Laboratory Experience

Abstract

Objective: Syndromic diagnostic testing is a relatively novel approach for the rapid diagnosis of central nervous system (CNS) infections. The aim of this study was to evaluate the rational use of the Food and Drug Administration (FDA)-approved meningitis/encephalitis panel for detecting CNS infections in critically ill patients. Materials and Methods: Cerebrospinal fluid (CSF) samples collected between December 2022 and December 2024 were analyzed using the QIAstat-Dx Meningitis/Encephalitis (QS-ME) panel kit. Patient demographics, clinical symptoms, and biochemical CSF parameters were retrospectively reviewed. Results: The study included 57 patients (34 male, 23 female) with a mean age of 48.9 ± 22.5 years. The overall positivity rate was 19.3% (n=11). Pathogens detected were varicella zoster virus (n=3), herpes simplex virus 1 (n=2), Streptococcus pneumoniae (n=2), Haemophilus influenzae (n=1), enterovirus (n=1), herpes simplex virus 2 (n=1), and human herpes virus 6 (n=1). The most frequent symptoms were headache and fever (54.5%, n=6), followed by loss of consciousness (45.5%, n=5), and vomiting (36.4%, n=4). Importantly, the positivity rates varied by department with 33.3% pediatrics, 30.0% infectious disease, 26.1% neurology, and 4.8% from the intensive care unit. Conclusion: To ensure cost effectiveness, QS-ME panel requests should be guided by clinical symptoms, biochemical CSF findings, and mandatory infectious disease consultation.

Keywords

• meningitis panel
• syndromic testing
• molecular testing

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