RT Journal Article
SR Electronic
T1 How appropriate are cerebrospinal fluid polymerase chain reaction requests for suspected central nervous system infections?
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 554
OP 557
DO 10.7861/clinmedicine.11-6-554
VO 11
IS 6
A1 Yaasir Mamoojee
A1 David Chadwick
YR 2011
UL http://www.rcpjournals.org/content/11/6/554.abstract
AB Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) assays have become the main diagnostic tests for central nervous system viral infections in recent years. Previous studies have suggested algorithms based on CSF leukocyte count and total protein levels to determine when CSF PCR assays are indicated. Based on these criteria, 1,469 CSF PCR tests requested over a two-year period were reviewed. A proportion of positive PCR results were found in children with normal CSF, unlike in adults where such occurrences were extremely rare. The results suggest that applying a strategy of screening CSF specimens using leukocyte count, glucose and protein, at least in adults, may have avoided more than half of CSF PCR requests with little detriment to patient care and considerable cost savings. Larger prospective studies are needed to determine whether algorithms using standard CSF parameters and clinical information can optimise the use of CSF PCR assays in clinical practice.