A STUDY OF CEREBROSPINAL FLUID CULTURE METHODS AMONG CHILDREN WITH ACUTE MENINGITIS

*Doaa Abdel-Moez Heiba

ABSTRACT

Background: Pediatric bacterial meningitis is a life-threatening problem. Despite advances in medical management, it still has a significant morbidity and mortality. For the prompt initiation of antibacterial therapy, rapid and reliable diagnostic methods are of utmost importance. It can be difficult to diagnose as the symptoms and signs are often non-specific, especially in young children, therefore, this study was designed to evaluate the ability of the BacT/ALERT system to recover microorganisms from CSF and compare it with conventional culture method and latex agglutination. Aim: The aim of the present study was to assess the diagnostic value of CSF culture (automated technique versus conventional) in the diagnosis of bacterial meningitis. Methods: A total of 50 CSF specimens, during one-year study period, were collected from children presenting to the emergency department in Alexandria university children hospital (AUCH) with suspected clinical signs and symptoms of bacterial meningitis. CSF specimens undergo physical examination, biochemical examination cytological examination and bacteriological examination, then patients were divided into two groups: bacterial group and non- bacterial group. Results: In current study, Most common manifestation was fever 92%, followed by vomiting 44% and most common clinical signs were nonspecific signs in 42% followed by neck rigidity in 30.0%. Regarding Bact/ALERT Culture from CSF 14 cases out of 50 showed positive result which is 28% of the total cases, and this represent 14 out of 30 cases (46.6%) positive from the bacterial group caused by Streptococcus pneumoniae in 7 cases (23.3%), Neisseria meningitidis in 3 cases (10.0%) followed by Hemophilus influenzae in 2 cases (6.7%). There was high statistical significance between both conventional culture and Bact/ALERT culture at p value 0.027*. Conclusion: In the current study, The BacT/ALERT culture for studied cases showed higher detection value in comparison with conventional culture and latex agglutination test. Gram staining was also found to be more superior to LAT and conventional culture in detection of bacteria but yet all were found to be less sensitive than Bact/ALERT. Abbreviations: ABM: acute bacterial meningitis, PMN: polymorphonuclear neutrophils, HIB: Hemophilus influenzae b, Group b streptococci.

Keywords: Bacterial meningitis, automated culture, CSF, conventional culture, diagnosis, Bact/ALER.