{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:40:39Z","timestamp":1785404439312,"version":"3.56.0"},"reference-count":30,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Delayed or incorrect treatment of meningitis may result in adverse patient outcomes. However, laboratory testing in resource-limited settings is often limited to conventional diagnostic methods. We explored the utility of syndromic molecular assays for diagnosis.\n\nObjectives:\u00a0We tested cerebrospinal fluid (CSF) specimens collected from patients with clinically suspected meningitis submitted to a tertiary hospital laboratory in January 2021 \u2013 May 2021. Primary microbiological analysis (culture, Gram stain and cytochemical analysis) was performed as part of routine testing.\n\nMethod:\u00a0Residual CSF specimens were tested using a bacterial triplex real-time polymerase chain reaction (PCR) assay and a syndromic multi-pathogen real-time PCR assay for the detection of up to 18 bacterial and viral pathogens. Pathogen detection was compared between conventional and molecular assays.\n\nResults:\u00a0A potential pathogen was detected in 6% (12\/188) and 47% (89\/188) of specimens on the triplex and the multi-pathogen assay, respectively. Epstein-Barr virus (49\/188; 26%), human herpes virus 7 (22\/188; 12%), herpes simplex virus 1 (13\/188; 7%) and\u00a0Streptococcus pneumoniae\u00a0(10\/188; 5%) were the leading pathogens detected on the syndromic multi-pathogen PCR. Further, using the multi-pathogen PCR assay, a potential pathogen was detected in 44% (73\/166) of the specimens which were negative following routine testing. Overall, combining routine testing and molecular platforms significantly improved pathogen detection (p\u00a0&lt; 0.001); a potential pathogen was identified in 51% (95\/188) of the specimens tested, compared to 12% (22\/188) using routine methods alone.\n\nConclusion:\u00a0The use of molecular tests improved pathogen detection by 39% when paired with routine methods.\n\nContribution:\u00a0Multi-pathogen molecular testing is useful for rapidly diagnosing meningitis cases.<\/jats:p>","DOI":"10.4102\/sajid.v39i1.688","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T07:23:23Z","timestamp":1733815403000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced pathogen identification among patients with clinically suspected meningitis"],"prefix":"10.4102","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4288-0555","authenticated-orcid":false,"given":"Malefu","family":"Moleleki","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6458-5189","authenticated-orcid":false,"given":"Pieter","family":"Nel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7048-8641","authenticated-orcid":false,"given":"Siphiwe R.","family":"Matukane","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7014-2539","authenticated-orcid":false,"given":"Stephanie","family":"Cloete","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2095-8019","authenticated-orcid":false,"given":"Zayaan","family":"Abrahams","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9526-0133","authenticated-orcid":false,"given":"Nicole","family":"Wolter","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9070-5247","authenticated-orcid":false,"given":"Andrew C.","family":"Whitelaw","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Wunrow HY, Bender RG, Vongpradith A, et al. 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