title: Rapid diagnosis of acute bacterial meningitis: role of a broad range 16S rRNA polymerase chain reaction.
abstract: BACKGROUND
  Acute bacterial meningitis is a significant cause of morbidity and mortality throughout the world. It can be difficult to diagnose, as the symptoms and signs are often non-specific.
  
  
  OBJECTIVE
  To evaluate the performance of an in-house semi-nested polymerase chain reaction (PCR) assay targeting the 16S rRNA gene of Eubacteria for the rapid diagnosis of acute bacterial meningitis using cerebrospinal fluid (CSF) specimens.
  
  
  METHODS
  A total of 112 CSF samples from 112 patients were used in the study. Among these, 32 samples were obtained from confirmed cases of Streptococcus pneumoniae, six samples were obtained from confirmed cases of Haemophilus influenzae, one sample from a confirmed case of Neisseria meningitidis, and 10 cases of clinically suspected acute bacterial meningitis. The remaining 63 CSF samples were obtained from patients with non-infectious illnesses (n = 47) of the central nervous system (CNS) and autopsy-confirmed tuberculous meningitis (n = 16).
  
  
  RESULTS
  The assay had an overall sensitivity of 93% (95% confidence interval [CI] 0.81-0.98, negative predictive value = 95%) and a specificity of 98% (95% CI 0.92-1.0, positive predictive value = 98%).
  
  
  CONCLUSIONS
  These preliminary findings suggest that the semi-nested PCR assay targeting the 16S rRNA gene may be used as a rapid test for the diagnosis of acute bacterial meningitis.
authors.affiliation: Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Wasiulla
authors.initials: W
authors.lastname: Rafi
authors.forename: Akepati
authors.initials: A
authors.lastname: Chandramuki
authors.forename: Reeta
authors.initials: R
authors.lastname: Mani
authors.forename: Parthasarathy
authors.initials: P
authors.lastname: Satishchandra
authors.forename: Sursarla Krishna
authors.initials: SK
authors.lastname: Shankar
mesh_terms: D000208:Acute Disease; D004269:DNA, Bacterial / Q000032:analysis; D004311:Double-Blind Method; D006192:Haemophilus Infections / Q000150:complications; D006193:Haemophilus influenzae / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000235:genetics* / Q000302:isolation & purification; D016870:Neisseriaceae Infections / Q000150:complications; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S; D013290:Streptococcal Infections / Q000150:complications / Q000235:genetics; D013296:Streptococcus pneumoniae / Q000235:genetics* / Q000302:isolation & purification; D013997:Time Factors
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S