1Suleyman Demirel University Faculty of Medicine, Department of Medical Microbiology, Isparta, Turkey 2Gelisim Medical Laboratories, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey


Introduction: This retrospective cross-sectional study was conducted to determine the prevalence of viral, bacterial, and fun- gal pathogens by using a multiplex real-time PCR assay in patients with suspected meningitis in Istanbul, Turkey.

Materials and methods: A total of 204 cerebrospinal fluid specimens were analyzed by using MeningoFinder 2Smart (PathoFinder BV, The Netherlands) and Rotor-Gene 6000 real-time PCR system (Qiagen, Germany).

Results: At least one pathogen was detected in 55 (27%) of all specimens. Overall, 57 pathogens were detected, and 30 (52.63%) of them were viruses, 26 (45.62%) were bacteria and 1 (1.75%) was fungus. In two cases, two pathogens (Epstein-Barr virus and Streptococcus agalactiae, Measles virus and Streptococcus pneumoniae) were found together. The detected pathogens were Haemophilus influenzae (n=14), Human herpesvirus 6 (n=13), Cytomegalovirus (n=9), S.pneumoniae (n=6), Epstein-Barr virus (n=5), S.agalactia (n=4), Parechovirus (n=1), Human herpesvirus 7 (n=1), Measles virus (n=1), Listeria monocytogenes (n=1), Borrelia burgdorferi/miyamatoi (n=1) and Cryptococcus neoformans (n=1). S.pneumoniae was the most common pathogen in 0-4- year-old age subgroup, H.influenzae in 5-15-year-old age subgroup and in 16-64-year-old age subgroup, and Cytomegalovirus in ≥ 65-year-old age subgroup. Viral infections occurred predominantly in the autumn (11/30, 36.6%) and summer (9/30, 30%) whereas bacterial infections in the autumn (10/26, 38.5%) and winter (8/26, 30.8%).

Conclusion: Herpesviruses and H.influenzae were found to be the major viral and bacterial causes of meningitis in the study. Our findings would contribute to the knowledge base on the epidemiology of meningitis in Istanbul.


cerebrospinal fluid, meningitis, multiplex PCR, prevalence