16S rDNA-PCR and Sequencing Improves Diagnosis of Bacterial Infection of the Central Nervous System

Rapid initiation of antibiotic treatment and fast diagnosis are essential in bacterial infection of the central nervous system (CNS). Culture as common method for detecting bacteria is time consuming and unreliable once antibiotic treatment has been initiated. Eubacterial 16S rDNA-PCR with species differentiation by sequencing appears to be a promising tool. Our experiences with this method performed on specimens from patients with neurological disorders between 2004 and 2006 are presented. The follow-up of 26 patients revealed bacterial infection in 12 cases (ten on effective antibiotics). The pathogen was identified in seven cases (one by culture and PCR, six by PCR alone). Additionally, two positive PCR-results failed to be sequenced, yet suggest bacterial infection. Contamination was revealed in two cases without infection, one by PCR and one by PCR and culture. In conclusion, 16S rDNA-PCR may be useful for diagnosis bacterial infection of CNS, especially after onset of antibiotic therapy.