Laboratory Diagnosis of Central Nervous System Infection.
Central nervous system (CNS) infections are potentially life threatening if not diagnosed and treated early. The initial clinical presentations of many CNS infections are non-specific, making a definitive etiologic diagnosis challenging. Nucleic acid in vitro amplification-based molecular methods are increasingly being applied for routine microbial detection. These methods are a vast improvement over conventional techniques with the advantage of rapid turnaround and higher sensitivity and specificity. Additionally, molecular methods performed on cerebrospinal fluid samples are considered the new gold standard for diagnosis of CNS infection caused by pathogens, which are otherwise difficult to detect. Commercial diagnostic platforms offer various monoplex and multiplex PCR assays for convenient testing of targets that cause similar clinical illness. Pan-omic molecular platforms possess potential for use in this area. Although molecular methods are predicted to be widely used in diagnosing and monitoring CNS infections, results generated by these methods need to be carefully interpreted in combination with clinical findings. This review summarizes the currently available armamentarium of molecular assays for diagnosis of central nervous system infections, their application, and future approaches.
Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518033, Guangdong Province, China.|Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Taojun
T
He
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Samuel
S
Kaplan
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.|Weill Medical College of Cornell University, 1300 York Avenue, New York, NY, 10065, USA.
Mini
M
Kamboj
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. tangy@mskcc.org.|Weill Medical College of Cornell University, 1300 York Avenue, New York, NY, 10065, USA. tangy@mskcc.org.
Yi-Wei
YW
Tang
Central nervous system infections; Culture; Encephalitis; Laboratory diagnosis; Meningitis; Microscopic morphology; Molecular methods; Pan-omic techniques; Rapid antigen testing; Serology
Am J Trop Med Hyg. 2015 Feb;92(2):274-9
25385864
J Clin Microbiol. 2010 Jul;48(7):2433-9
20421442
Ir J Med Sci. 2014 Mar;183(1):85-8
23864405
Clin Neurol Neurosurg. 2015 Feb;129:67-71
25553519
J Med Virol. 2016 Jan;88(1):175-9
26118835
Pediatr Neurol. 2015 Jul;53(1):3-12
25957806
BMC Pediatr. 2012 Sep 07;12:145
22958329
J Clin Microbiol. 1998 Jun;36(6):1617-20
9620388
J Microbiol. 2015 Jan;53(1):1-5
25557475
Curr Opin Virol. 2015 Apr;11:44-54
25681709
Brain Nerve. 2015 Jul;67(7):799-811
26160810
J Med Microbiol. 2015 Nov;64(11):1321-8
26253287
J Clin Microbiol. 2015 Jan;53(1):319-22
25378578
BMC Infect Dis. 2015 Aug 19;15:351
26286439
Lancet. 2001 May 12;357(9267):1499-500
11377604
Int J Tuberc Lung Dis. 2015 Jan;19(1):74-80
25519794
Brain Nerve. 2015 Jul;67(7):931-9
26160820
Curr Infect Dis Rep. 2002 Aug;4(4):339-350
12126611
J Clin Microbiol. 2013 Nov;51(11):3765-9
24006008
J Clin Microbiol. 2005 Jun;43(6):2616-23
15956374
Ann Clin Microbiol Antimicrob. 2016 Apr 21;15:26
27101869
J Virol Methods. 2014 Apr;199:29-34
24418499
Korean J Pediatr. 2015 Nov;58(11):446-50
26692881
J Neuroimmune Pharmacol. 2013 Dec;8(5):1136-46
24203462
Bone Marrow Transplant. 2012 Jun;47(6):846-54
21927034
J Forensic Leg Med. 2015 Feb;30:21-4
25623190
J Clin Virol. 2015 Jan;62:103-5
25464965
Rev Chil Pediatr. 2016 Jan-Feb;87(1):24-30
26493774
J Virol Methods. 2013 Jun;190(1-2):53-62
23458694
MBio. 2015 Dec 08;6(6):e01888-15
26646014
Clin Infect Dis. 2015 Mar 15;60(6):881-8
25572899
Brain Pathol. 2015 Sep;25(5):600-4
26276023
FEBS Lett. 2016 Feb;590(4):509-19
26801203
J Clin Virol. 2015 Jan;62:58-62
25542472
PLoS One. 2015 Mar 23;10(3):e0118529
25799541
Clin Infect Dis. 2013 Dec;57 Suppl 3:S139-70
24200831
N Engl J Med. 2016 Mar 10;374(10 ):951-8
26862926
J Clin Microbiol. 2014 May;52(5):1751-3
24622094
AIDS. 2015 Mar 13;29(5):559-69
25611149
Continuum (Minneap Minn). 2015 Dec;21(6 Neuroinfectious Disease):1704-13
26633784
Indian J Med Res. 2012 May;135(5):695-702
22771604
J Clin Microbiol. 2011 Oct;49(10):3621-6
21832019
JAMA. 2000 May 24-31;283(20):2680-5
10819951
Lancet. 1990 Feb 24;335(8687):440-1
1968171
Clin Chem. 2001 Aug;47(8):1559-62
11468267
AIDS. 2014 Jul 17;28(11):1579-91
24752083
J Acquir Immune Defic Syndr. 2015 Apr 15;68 Suppl 3:S331-9
25768872
Int J Tuberc Lung Dis. 2015 Oct;19(10):1209-15
26459535
FEMS Microbiol Lett. 2012 Dec;337(1):25-30
22946506
Rinsho Shinkeigaku. 2013;53(11):1184-6
24291923
Expert Opin Med Diagn. 2007 Dec;1(4):489-509
23496356
J Immunol. 2015 Sep 1;195(5):2251-62
26202983
J Pediatric Infect Dis Soc. 2016 Sep;5(3):277-86
26407252
Front Microbiol. 2016 Jan 12;6:1548
26793181
Brain Behav Immun. 2017 Feb;60:1-12
26995317
Clin Infect Dis. 2011 Nov;53(10):1019-23
21940419
Biochem Biophys Res Commun. 2015 Oct 30;466(4):689-95
26348777
PLoS One. 2012;7(8):e42954
22900070
J Mol Diagn. 2011 Nov;13(6):583-604
21871973
Clin Infect Dis. 2015 Mar 15;60(6):919-23
25572898
Ann Neurol. 2015 Nov;78(5):722-30
26290222
Virol J. 2013 Oct 22;10:311
24148652
J Virol. 2014 May;88(9):4798-810
24522920
J Clin Virol. 2015 Jul;68:53-5
26071336
J Clin Microbiol. 2011 Feb;49(2):528-33
21159942
Curr Drug Metab. 2015;16(2):105-23
26179607
Zhonghua Yi Xue Za Zhi. 2015 Dec 8;95(46):3733-6
26850011
MBio. 2016 Jan 26;7(1):e01906-15
26814182
J Clin Microbiol. 2009 Apr;47(4):908-13
19193844
Clin Infect Dis. 2003 Mar 15;36(6):731-42
12627357
Eur Respir J. 2014 Aug;44(2):435-46
24696113
Diagn Microbiol Infect Dis. 2016 Mar;84(3):268-73
26711635
Curr Opin Neurol. 2015 Jun;28(3):277-82
25887770
Clin Infect Dis. 2000 Sep;31(3):739-51
11017824
J Clin Microbiol. 2014 Jan;52(1):226-33
24197880
Eur J Clin Microbiol Infect Dis. 2014 Dec;33(12):2083-93
24935615
J Virol Methods. 2015 Mar;213:98-105
25512133
PLoS Med. 2013 Oct;10(10):e1001536
24167451
J Clin Virol. 2008 Sep;43(1):96-101
18674965
J Clin Microbiol. 2005 Nov;43(11):5828-9
16272534
J Clin Virol. 2005 Mar;32(3):236-40
15722029
Electron Physician. 2015 Dec 20;7(8):1609-12
26816587
Int J Mol Med. 2015 May;35(5):1323-32
25760060
Respirology. 2013 Feb;18(2):217-32
23190246
BMC Infect Dis. 2014 May 09;14:246
24884467
Mem Inst Oswaldo Cruz. 2014 Feb;109(1):29-37
24626307
Clin Infect Dis. 2006 Dec 15;43(12):1578-9
17109291
Clin Perinatol. 2015 Mar;42(1):29-45, vii-viii
25677995
Clin Microbiol Infect. 2015 Aug;21(8):799.e5-7
25964153
Herpes. 2004 Jun;11 Suppl 2:57A-64A
15319091
PLoS One. 2012;7(9):e44630
22984534
Lancet Neurol. 2009 Aug;8(8):731-40
19608099
Ann Intern Med. 1973 Oct;79(4):603-4
4127061
Clin Infect Dis. 2016 May 1;62(9):1133-5
26966284
N Engl J Med. 2014 Jun 19;370(25):2408-17
24896819