关键词: 儿童, 脑膜炎, 脑炎, 巢式多重聚合酶链反应

Abstract:

Objective To investigate the clinical role of nested multiple polymerase chain reaction（PCR） in the diagnosis of meningitis/encephalitis in children. Methods The cerebrospinal fluid samples of 82 children diagnosed or suspected central nervous system infection in Shanghai Children's Hospital from May 2017 to May 2020 were collected in a retrospective case-control study. The clinical data of children were collected. The use of antibiotics was understanded. The pathogen infection was determined by nested multiple PCR. Bacteria were cultured，and routine test and biochemical determination of cerebrospinal fluid were carried out. Results Totally，31 positive cases were determined，which included 20 cases of viruses and 11 cases of bacteria. The cerebrospinal fluid white blood cell count，protein and lactate dehydrogenase levels，antibiotic use days and hospital stay in bacterial group were higher than those in viral group（P<0.05），while the glucose level was lower than that in viral group（P<0.05），and the cases of using acyclovir were less than those in viral group（P<0.05）. Nested multiple PCR with culture method in bacterial meningitis/encephalitis had good consistency（Kappa =0.659，P<0.001），and nested multiple PCR with routine test and biochemical determination in viral meningitis/encephalitis had good consistency as well （Kappa =0.737，P<0.001）. Conclusions Nested multiple PCR could be used as a new method to assist in the diagnosis of cerebrospinal fluid pathogen infection and improve the diagnostic efficiency of meningitis/encephalitis.

Key words: Children, Meningitis, Encephalitis, Nested multiple polymerase chain reaction