Effective use of polymerase chain reaction for diagnosis of central nervous system infections.

摘要: Polymerase chain reaction (PCR)-based testing of cerebrospinal fluid (CSF) specimens has become standard for confirmatory diagnosis central nervous system (CNS) infections; however, these tests increase health care costs. We reviewed 3-year data from 974 consecutive CSF submitted detection seven pathogens by PCR. In 1997, 237 367 (64.6%) were multiple tests, compared with 203 522 (38.9%) in 1996 and 18 85 (21.2%) 1995. each year the arrival new house officers coincided a peak testing. Among 732 herpesvirus detection, results positive 24 (4.6%) 523 increased leukocyte counts or protein levels. None 209 normal levels herpesviruses. 471 Borrelia burgdorferi PCR-positive. Use leukocytes to screen before employing PCR would save almost one-third costs without reducing sensitivity.