<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-1249</journal-id>
<journal-title><![CDATA[Archivos de Pediatría del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Pediatr. Urug.]]></abbrev-journal-title>
<issn>1688-1249</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-12492025000201503</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Resultados de la implementación de técnicas de biología molecular en el estudio del líquido cefalorraquídeo de niños, niñas y adolescentes asistidos en un hospital de referencia]]></article-title>
<article-title xml:lang="en"><![CDATA[Results of the implementation of molecular biology techniques in the study of cerebrospinal fluid of children and adolescents assisted at a reference children&#8217;s hospital]]></article-title>
<article-title xml:lang="pt"><![CDATA[Resultados da aplicação de técnicas de biologia molecular no estudo do líquido cefalorraquidiano em crianças e adolescentes assistidos em um hospital pediátrico de referencia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez]]></surname>
<given-names><![CDATA[Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cornejo]]></surname>
<given-names><![CDATA[Cecilia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Desiderio]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Algorta]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Varela]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mota]]></surname>
<given-names><![CDATA[Ma. Inés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Bacteriología y Virología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,CHLA-EP Laboratorio Nacional de Referencia Microbacterianas ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,ASSE CHPR ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,UDELAR Facultad de Medicina Unidad Académica Bacteriología y Virología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>96</volume>
<numero>nspe1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-12492025000201503&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-12492025000201503&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-12492025000201503&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary  Introduction:  meningoencephalitis (ME) is a serious disease that can be life-threatening and cause long-term sequelae. Typically, the etiological diagnosis of ME is based on direct examination, culture, and more recently, the detection of soluble antigens in cerebrospinal fluid (CSF) and the molecular detection of viral agents. In 2015, the FDA approved the first multiplex PCR assay for the simultaneous detection of viruses, bacteria, and parasites associated with community-acquired ME and ME in immunocompromised patients, with an approximate turnaround time of 1 hour.  Objectives:  describe the agents detected by real-time PCR in the population assisted at a reference pediatric hospital. Compare the performance of direct examination and CSF culture versus molecular detection with the ME panel. Analyze the predictive value of the CSF cytochemical study.  Methodology:  observational, descriptive study. We included all children assisted at a reference pediatric hospital from whom a CSF sample was sent to the microbiology laboratory for bacteriological and/or virological study. CSF samples were analyzed by direct examination, culture, and nucleic acid detection with the BioFire FilmArray ME panel (Biomerieux) or QIAstat-Dx (Qiagen), regardless of the cytochemical study result. The results were analyzed retrospectively by reviewing laboratory databases. Period: January 2016 - June 2024. Qualitative variables are expressed as absolute and relative percentage frequencies.  Results:  834 CSF samples were processed: 155 (18.6%) were positive with the ME panel, and 19 (2.3%) were invalid. Viral agents were detected in 60% of the positive samples, bacterial agents in 37.5%, and yeasts in 2.5%. More than one agent was detected in 3.9% of the samples. The most frequent viruses were human herpesvirus 6 (47) and enterovirus (32). The most frequent bacterium was Neisseria meningitidis (31), followed by Haemophilus influenzae (13) and Streptococcus agalactiae (8). Of the samples with molecular detection of bacteria: CSF culture was positive in 48.3%, and blood culture recovered 6.7% of additional agents; bacteria were observed in the direct examination in 43.3%, and 94.7% had a typical profile of acute bacterial meningitis in the cytochemical study. In contrast, of the samples with viral detection, only 22.6% had altered CSF cytochemistry.  Conclusions:  human herpesvirus 6, enterovirus, and N. meningitidis were the most frequently detected pathogens. However, the detection of human herpesvirus 6 does not always indicate an active infection and may correspond to a latent infection. Therefore, it is crucial to interpret PCR results within the patient&#8217;s clinical environment. Bacterial etiological diagnosis using the ME panel doubled the recovery of culture. Given that meningococcal meningitis is a vaccine-preventable disease, universal immunization would significantly improve the current epidemiological situation.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  a meningoencefalite (ME) é uma doença grave que pode comprometer a vida, bem como gerar sequelas a longo prazo. Classicamente, o diagnóstico etiológico da ME baseia-se no exame direto, cultura e, mais recentemente, na detecção de antígenos solúveis no líquido cefalorraquidiano (LCR) e na detecção por biologia molecular de agentes virais. No ano de 2015, o FDA aprovou o primeiro ensaio de PCR multiplex para a detecção simultânea de vírus, bactérias e parasitas associados à ME adquirida na comunidade e ME em pacientes imunocomprometidos, com um tempo de resposta aproximado de 1 hora.  Objetivos:  descrever os agentes detectados por PCR em tempo real na população assistida em um hospital pediátrico de referência. Comparar o desempenho do exame direto e cultura do LCR versus a detecção molecular com painel ME. Analisar o valor preditivo do estudo citoquímico do LCR.  Metodologia:  estudo observacional, descritivo. Foram incluídas todas as crianças assistidas em um hospital pediátrico de referência das quais uma amostra de LCR foi enviada ao laboratório de microbiologia para estudo bacteriológico e/ou virológico. As amostras de LCR foram analisadas por exame direto, cultura e detecção de ácidos nucleicos com painel ME BioFire FilmArray (Biomerieux) ou QIAstat-Dx (Qiagen), independentemente do resultado do estudo citoquímico. Os resultados foram analisados retrospectivamente por meio da revisão de bancos de dados do laboratório. Período: janeiro de 2016 - junho de 2024. As variáveis qualitativas são expressas em frequências absolutas e relativas percentuais.  Resultados:  foram processadas 834 amostras de LCR: 155 (18,6%) foram positivas com o painel ME, e 19 (2,3%) foram inválidas. Agentes virais foram detectados em 60% das amostras positivas, agentes bacterianos em 37,5% e leveduras em 2,5%. Houve detecção de mais de um agente em 3,9% das amostras. Os vírus mais frequentes foram o vírus herpes humano 6 (47) e enterovírus (32). A bactéria mais frequente foi Neisseria meningitidis (31), seguida por Haemophilus influenzae (13) e Streptococcus agalactiae (8). Das amostras com detecção molecular de bactérias: a cultura de LCR foi positiva em 48,3% e a hemocultura recuperou 6,7% de agentes adicionais; em 43,3% foram observadas bactérias no exame direto e 94,7% tiveram perfil típico de meningite bacteriana aguda no estudo citoquímico. Em contraste, das amostras com detecção viral, apenas 22,6% apresentaram citoquímico de LCR alterado.  Conclusões:  vírus herpes humano 6, enterovírus e N. meningitidis foram os patógenos mais frequentemente detectados. No entanto, a detecção de vírus herpes humano 6 nem sempre indica uma infecção ativa, podendo corresponder a uma infecção latente. Portanto, é crucial interpretar os resultados da PCR no contexto clínico do paciente. O diagnóstico etiológico bacteriano por meio do painel ME dobrou a recuperação da cultura. Dado que a meningite meningocócica é uma doença prevenível por vacinação, a imunização universal melhoraria significativamente a situação epidemiológica atual.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Biología Molecular]]></kwd>
<kwd lng="es"><![CDATA[Líquido Cefalorraquídeo]]></kwd>
<kwd lng="en"><![CDATA[Molecular Biology]]></kwd>
<kwd lng="en"><![CDATA[Cerebrospinal Fluid]]></kwd>
<kwd lng="pt"><![CDATA[Biologia Molecular]]></kwd>
<kwd lng="pt"><![CDATA[Líquido Cefalorraquidiano]]></kwd>
</kwd-group>
</article-meta>
</front>
</article>
