Cerebrospinal fluid multiplex PCR cycle thresholds may predict ICU admission in community-acquired meningoencephalitis

Diagn Microbiol Infect Dis. 2025 Mar;111(3):116704. doi: 10.1016/j.diagmicrobio.2025.116704. Epub 2025 Jan 27.

Abstract

Objective: We investigated the relationship between cerebrospinal fluid (CSF) PCR cycle threshold (Ct) values, clinical characteristics, and outcomes in suspected CAM, while assessing QIAstat-Dx® ME Panel concordance with routine diagnostic methods.

Methods: Frozen CSF from 30 individuals with suspected CAM were analyzed using the QIAstat-Dx® ME Panel. Ct values were categorized as low (≤ 30) or high (>30). Concordance with CSF FilmArray®/culture results was assessed using the Kappa coefficient.

Results: Low Ct values were associated to CSF markers of meningitis and predicted ICU admissions (log-rank P = 0.025), particularly within the first two weeks of hospitalization (85 % for low Ct values versus 50 % for high Ct values, P = 0.041). Ct values were not associated with mortality in the survival analysis (log-rank P = 0.109). Substantial agreement was observed between QIAstat-Dx® and comparators (96.7 %, Kappa 0.839).

Conclusions: CSF Ct values can assist in risk stratification for timely ICU admission in individuals with CAM.

Keywords: Community acquired meningoencephalitis; Cycle thresholds; Intensive care; Polymerase chain reaction.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrospinal Fluid* / microbiology
  • Community-Acquired Infections* / cerebrospinal fluid
  • Community-Acquired Infections* / diagnosis
  • Community-Acquired Infections* / microbiology
  • Female
  • Humans
  • Intensive Care Units* / statistics & numerical data
  • Male
  • Meningoencephalitis* / cerebrospinal fluid
  • Meningoencephalitis* / diagnosis
  • Meningoencephalitis* / microbiology
  • Middle Aged
  • Multiplex Polymerase Chain Reaction* / methods
  • Patient Admission