Diagnostic value of cytokine assays in cerebrospinal fluid in culture-negative, polymerase chain reaction-positive bacterial meningitis

Analysis of bacterial DNA using a polymerase chain reaction performed with broad-range eubacterial 16S rDNA primers may yield a diagnosis of bacterial meningitis in cases where Gram staining of cerebrospinal fluid (CFS), anti gen detection techniques or culture fail. Since this PCR technique occasion ally gives false-positive results due to contamination of samples or labora tory reagents, a study was performed to establish the diagnostic value of a ssaying concentrations of tumour necrosis factor-alpha (TNF-alpha) and inte rleukin-10 (IL-10) in 90 CSF samples. A high correlation was found between a positive PCR result and the concentrations of TNF-alpha and IL-10, indica ting that cytokine assays may be used as a confirmatory test. The findings suggested that a combination of the PCR technique, amplicon sequencing and assay of TNF-alpha and IL-10 concentrations in CSF is a reliable and cost-e ffective procedure for diagnosis of culture-negative bacterial meningitis.