Aetiological diagnostics of acute bacterial meningitis in children

Abstract

Aetiology of bacterial meningitis (BM) can be confirmed by various microbiological methods. The aim of this study was to assess the role of microbiological methods used for confirmation of BM in children and determine the influence of the aetiological agent, patient age and antibacterial treatment on study results. Over a 5-y period (1998-2002) BM was diagnosed in 90 children at Vilnius University Centre for Paediatrics. Aetiology was confirmed by cerebrospinal fluid (CSF) and blood culture, microscopic CSF smear examination, CSF and blood latex agglutination test. CSF and blood cultures were positive in 53% and 39% of cases, respectively. Microscopic CSF smear examination was positive for 57% of the specimens. CSF latex agglutination was positive in 64% and blood in 47% of cases. Causative agent and received antibiotic therapy prior to investigation of obtained material affected some final microbiological results. However, no influence of patient age was found. Microbiological confirmation was achieved in 59% of cases using CSF and/or blood culture and in 78% of cases using all available methods in practice. The most common pathogens of bacterial meningitis were H. influenzae type b, N. meningitidis and S. pneumoniae.

Differential diagnosis of acute central nervous system infections in children using modern microbiological methods

“…In addition, three probable cases were identified, and only seven cases remained aetiologically entirely unknown. These results compete well with other studies (1,3), one of those being a recent analysis of adult patients in Finland (10), in which the aetiology of aseptic meningitis was identified in 66%. We did so in 70% (14/20) of our paediatric patients.…”

“…Specific aetiological diagnosis of acute central nervous system (CNS) infection in a child is a continuous challenge to paediatrician (1,2). The agents causing bacterial meningitis in industrialized countries are identified in more than 80% of cases (3), but in aseptic meningitis, and especially encephalitis, the aetiology remains more often unknown than settled (1). Several reasons explain this shortcoming: clinical samples are not always optimal for the assays used, some agents are not detected with the methods available, and lamentably, some molecular methods may be too expensive for routine use.…”

Latex Agglutination Test for Early Detection of Causative Organism in Acute Bacterial Meningitis

“…This is in accordance to the organisms isolated from CSF in other studies 6,7,8,9 . Seasonal variation in the incidence of meningococcal meningitis and vaccination against it might have accounted for the fact that Neisseria meningitidis was not isolated in any of the CSF samples in our study.…”

Predicting Neurological Complications Following Acute Bacterial Meningitis in Children Versus Adults

“…Several rapid diagnostic tests have been developed. Latex agglutination test detected bacterial antigens in 64% of cases (Narkeviciute et al, 2006). A broad range bacterial PCR assay is available for the early detection of bacterial meningitis with sensitivity (100%) and specificity (98.2%), also, the detect DNA of all meningeal pathogens (Saravolatz et al, 2003).…”