NOTES Broad-Range 16S rRNA PCR with Cerebrospinal Fluid May Be Unreliable for Management of Postoperative

We previously demonstrated that discontinuing presumptive antibiotic treatment in cases of negative conventional cultures is safe and effective for patients with postoperative aseptic meningitis (PAM). Here, we prospectively investigated 32 patients with postoperative meningitis. All 26 patients with PAM diagnosed on the basis of conventional cultures demonstrated negative 16S rRNA PCR results. Our results suggest that the PCR technique does not change PAM management. Postoperative meningitis is a rare but life-threatening infec-tion (6, 9, 13). Aseptic postoperative meningitis may account for up to 70 % of all cases of postoperative meningitis (13, 15). Aseptic meningitis may be due to a local inflammatory reaction to blood breakdown products, sutures, tissue breakdown prod-ucts, chemicals, etc. (7, 8), or to a small bacterial inoculum acquired perioperatively (5). Distinction between the two en-tities is clinically very difficult, and the results for direct bac-teriological examination are often negative (1). Rapid diagno-sis of postoperative bacterial meningitis is crucial, as th