Laboratory diagnosis of bacterial meningitis

Gray, Laura; Fedorko, Danielp .

doi:10.1128/cmr.5.2.130

Cited by 194 publications

(68 citation statements)

References 125 publications

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“…Among the routine tests used for the etiologic diagnosis of bacterial meningitis, bacterial culture is considered the gold standard. However, this is a time-consuming technique, which re q u i res viable micro o rganisms for cultivation, and its sensitivity is directly affected by the start of antibiotic t reatment before spinal tap 5 . Other faster tests, such as latex agglutination, have a lower sensitivity and p resent reliable results only with samples containing more than 105 CFU/mL 6 .…”

Section: Pa L Av R a S -C H Ave: Reação Em Cadeia Da Polimerase (Pcr)mentioning

confidence: 99%

Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae and Streptococcus sp. by polymerase chain reaction for the diagnosis of bacterial meningits

Failace

Wagner

Chesky

et al. 2005

Arq. Neuro-Psiquiatr.

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Dra. Luciane Failace -Rua Carlos Von Koseritz 1353/201 -90540-031 Porto Alegre RS -Brasil. Acute bacterial meningitis is responsible for m o s t infections affecting the central nervous system ( C N S ) .Close to two-thirds of all cases occur among child ren, and Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae are the pathogens responsible for 80 to 90% of the case s 1 , 2 . A rapid and precise etiologic diagnosis of bacterial meningitis is essential to determine adequate t reatment, and it can also significantly reduce mortality and the risk for long-term sequelae 3 .In epidemiological terms, the diagnosis of bacterial meningitis may indicate the need for selective immu- PA L AV R A S -C H AVE: reação em cadeia da polimerase (PCR), meningite bacteriana, líquido cefalorr a q u i d iano (LCR).

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Section: Pa L Av R a S -C H Ave: Reação Em Cadeia Da Polimerase (Pcr)mentioning

confidence: 99%

Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae and Streptococcus sp. by polymerase chain reaction for the diagnosis of bacterial meningits

Failace

Wagner

Chesky

et al. 2005

Arq. Neuro-Psiquiatr.

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“…It is known that for the classical pathogen of bacterial meningitis, the Gram stain is about 80% sensitive, 12 but for Gram-negative bacilli, its sensitivity is only 50%. 13 It has been recorded that with a concentration of 10 3 cfu/mL, the Gram stain detection is 60%, whereas with 10 5 cfu/mL, the detection is 90%. 13 Since the concentration of nonclassic pathogens is generally low, it affects the sensitivity of the Gram stain.…”

Section: Discussionmentioning

confidence: 99%

“…13 It has been recorded that with a concentration of 10 3 cfu/mL, the Gram stain detection is 60%, whereas with 10 5 cfu/mL, the detection is 90%. 13 Since the concentration of nonclassic pathogens is generally low, it affects the sensitivity of the Gram stain. To overcome this problem, concentration of CSF by cytospin centrifugation has been suggested to increase the yield on Gram-stained CSF.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Pathogens and Utility of Latex Agglutination Tests in Bacterial Meningitis

et al. 2002

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The etiology of bacterial meningitis has changed significantly in the last decade, especially in the developed countries. 1 The classic bacterial pathogens of meningitis have been Haemophilus influenzae B, Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli and group B Streptococcus. Their relative importance varies according to the location and population characteristics. 2 In 1984, Babiker et al. reported 140 cases of bacterial meningitis from Riyadh, of which 90% were children under five years of age. The most common bacterial isolates in that study were E. coli from neonates and S. pneumoniae from children >2 months of age. 3 Later, an 11-year study reported H. influenzae B as a significant isolate in cases of meningitis in Riyadh, and recommended nationwide immunization against this pathogen. 4 Following an outbreak of meningococcal meningitis in 1988 in Makkah, a program of free nationwide vaccination against N. meningitides serogroup A and C has been in force. 5 Cost containment pressures have driven policy makers to critically appraise recommendations for latex agglutination tests (LAT) on cerebrospinal fluid (CSF). 6 Savings from their use and the fact that there is no change of empirical antibiotic therapy even after a positive test, have been cited in favor of abandoning the routine use of LAT. [6][7][8] In our laboratory, LAT is performed only in cases where the CSF cell count is elevated (>5 cell/mm 3 ) and the gram stain is negative, or when clinical suspicion is strong and prior antibiotic therapy is expected to reduce the yield of culture. In our institution, we process an average of 20 specimens of CSF/week. One LAT costs approximately 16 Saudi Riyals ($4.2). The saving/week is estimated at 19x16 =SR302 ($80).Aiming to address future concerns with the changing microbial pathogens of bacterial meningitis and problems with newer diagnostic implements, we undertook this study to determine the pattern of classical and non-classical bacterial isolates from CSF specimens, the usefulness of the gram stain and use of the LAT, and their implications on clinical decisions. It is pertinent to mention that this study is related to a tertiary care center, and by no means reflecting what happens in hospitals managing cases of community acquired meningitis. Materials and MethodsThe study sample consisted of 4180 CSF specimens, which were received during a four-year period (January 1995 to December 1998) by the Microbiology Laboratory at the King Khalid University Hospital, a 750-bed tertiary care general teaching hospital in Riyadh. All patients were highly suspected to have meningitis. Data were obtained from the laboratory records. In the vast majority of patients, a single CSF specimen was obtained from each patient. In a few cases, more than one specimen was obtained. Biochemical and Hematological TestsProtein and glucose levels were determined using the Dade autoanalyzer. Cerebrospinal cell counting was performed with the Neubaur Chamber. CSF specimen with protein levels of >45 mg/dL, and/o...

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“…In the present study, almost 90% of the patients had CSF culture examinations; however, blood culture was taken in 68% of cases. Bacteria can be detected by Gram smears in 60%-90% of patients with ABM (13). The presence of an organism upon CSF Gram stain may suggest bacterial etiology 1 day or more before culture results are available (14).…”

Section: Discussionmentioning

confidence: 99%

Is the diagnosis and treatment of childhood acute bacterial meningitis in Turkey evidence-based?

Türel¹,

Bakır²

2014

Turk J Med Sci

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Laboratory diagnosis of bacterial meningitis

Cited by 194 publications

References 125 publications

Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae and Streptococcus sp. by polymerase chain reaction for the diagnosis of bacterial meningits

Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae and Streptococcus sp. by polymerase chain reaction for the diagnosis of bacterial meningits

Pattern of Pathogens and Utility of Latex Agglutination Tests in Bacterial Meningitis

Is the diagnosis and treatment of childhood acute bacterial meningitis in Turkey evidence-based?

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