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Rapid diagnosis of bacterial meningitis by an enzyme immunoassay of cerebrospinal fluid

Published online by Cambridge University Press:  15 May 2009

M. A. M. Salih ,
H. S. Armed ,
Y. Hofvander ,
D. Danielsson  and
P. Olcén
M. A. M. Salih
Affiliation:
Departments of Pediatrics and Child Health
H. S. Armed
Affiliation:
Departments of Microbiology, Faculty of Medicine, University of Khartoum, Sudan
Y. Hofvander
Affiliation:
International Child Health Unit, Department of Pediatrics, University Hospital, Uppsala, Sweden
D. Danielsson
Affiliation:
Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden
P. Olcén*
Affiliation:
Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden
*
*Per Olcén, Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, S-701 85 Örebro, Sweden
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A total of 250 cerebrospinal fluid (CSF) specimens were analyzed using a rapid enzyme immunoassay (Pharmacia Meningitis ETA-Test) (EIA) for the detection of antigens of Haemophilus influenzae type b, Neisseria meningitidis (serogroups A, B, C) and Streptococcus pneumoniae (25 selected types). The test is performed in less than 1 h and read by the naked eye. EIA and coagglutination (CoA) were compared with a constructed reference that comprised samples which were either positive by culture and/or on direct microscopy (DM), or in which there were positive results with both EIA and CoA for the bacteria covered by the assays. Using this reference for CSF samples assayed in a period between two meningococcal meningitis epidemics, the sensitivity was 0·86 for EIA and 0·69 for CoA, the specificity 0·95 (EIA) and 0·97 (CoA), the predictive value for a positive result 0·81 (ETA) and 0·87 (CoA) and, the predictive value for a negative result 0·96 (EIA) and 0·93 (CoA). Antibiotics had been given to 54% of the patients before admission. All of the 56 samples that were positive in any of the tests taken during an epidemic of group A meningococcal disease were detected by EIA; CoA was negative in 45% and culture/DM was negative in 32%. Sequential dilutions of two CSF samples from which H. influenzae type b had been isolated, showed the EIA to be 16–32 times more sensitive than CoA. With both technical feasibility and good sensitivity and specificity, the EIA seems to be useful and reliable for the rapid diagnosis of bacterial meningitis, especially in situations where pretreatment with antibiotics are likely.

Type
Research Article
Information
Epidemiology & Infection , Volume 103 , Issue 2 , October 1989 , pp. 301 - 310
Copyright
Copyright © Cambridge University Press 1989

References

REFERENCES

1.Brown, KGE.Meningitis in Queen Elizabeth Central Hospital, Blantyre Malawi. East Afr J Med 1975; 52: 376–85.Google Scholar
2.Hailemeskel, H, Tafari, N.Bacterial meningitis in childhood in an African City: Factors influencing aetiology and outcome. Acta Pediatr Scand 1978; 67: 725–30.CrossRefGoogle Scholar
3.Nottidge, VA.Haemophilus influenzae meningitis: a 5-year study in Ibadan, Nigeria. J Infect 1985; 11: 109–17.CrossRefGoogle ScholarPubMed
4.Granoff, DM, Daum, RS.Spread of Haemophilus influenzae type b: Recent epidemiologic and therapeutic considerations. J Pediatr 1980; 97: 854–60.Google Scholar
5.Salwén, KM, Vikerfors, T, Olcén, P.Increased incidence of childhood bacterial meningitis. Scand J Infect Dis 1987; 19: 1–11.Google Scholar
6.Lapeyssonie, L, La méningite cérébro-spinale en Afrique. Bull WHO 1963; 28 (Suppl.): 3–114.Google Scholar
7.Sippel, JE, Sid Ahmed, H, Mikhail, IA.Epidemiologic studies on meningococcal meningitis in the Sudan. Med Trop 1983; 43: 39–41.Google Scholar
8.Greenwood, BM, Wali, SS.Control of meningococcal infection in the African Meningitis Belt by selective vaccination. Lancet 1980; 1: 729–32.Google Scholar
9.Kaplan, SL, Fishman, MA.Update on bacterial meningitis. J Child Neurol 1988; 3: 82–93.CrossRefGoogle ScholarPubMed
10.Edwards, EA, Muehl, PM, Peckinpaugh, RO.Diagnosis of bacterial meningitis by counter-immunoelectrophoresis. J Lab Clin Med 1972; 80: 449–54.Google Scholar
11.Newman, RB, Stevens, RW, Gaafar, HA.Latex agglutination test for the diagnosis of H. influenzae type b meningitis. J Lab Clin Med 1970; 76: 107–13.Google Scholar
12.Olcén, P, Danielsson, D, Kjellander, J.The use of protein A – containing staphylococci sensitized with anti-meningococcal antibodies for grouping Neisseria meningitidis and demonstration of meningococcal antigen in CSF. Acta Path Microbiol Scand 1975; (Section B) 83: 387–96.Google Scholar
13.Thirmumoorthi, MC, Dajani, AS.Comparison of staphylococcal coagglutination. latex agglutination and counter-immunoelectrophoresis for bacterial antigen detection. J Clin Microbiol 1979; 9: 28–32.Google Scholar
14.Drow, DL, Welch, DF, Hensel, D, Eisenach, K, Long, E, Slifkin, M.Evaluation of the Phadebact CSF Test for detection of the four most common causes of bacterial meningitis. J Clin Microbiol 1983; 18: 1358–61.CrossRefGoogle ScholarPubMed
15.Olcén, P.Serological methods for rapid diagnosis of Haemophilus influenzae. Neisseria meningitidis and Streptococcus pneumoniae in cerebrospinal fluid: a comparison of coagglutination, immunofluorescence and immunoelectroosmophoresis. Scand J Infect Dis 1978; 10: 283–9.Google Scholar
16.Wasilaukas, BL, Hampton, KD.Determination of bacterial meningitis: a retrospective study of 80 cerebrospinal fluid specimens evaluated by four in vitro methods. J Clin Microbiol 1982: 16; 531–5.CrossRefGoogle Scholar
17.Kaplan, SL.Antigen detection in CSF – pros and cons. Am J Med 1983; 75 (Suppl 1B): 109–18.CrossRefGoogle Scholar
18.Drow, DL, Maki, DG, Manning, DD.Indirect sandwich enzyme-linked immunosorbent assay for rapid detection of haemophilus type b infection. J Clin Microbiol 1979; 10: 442–50.CrossRefGoogle ScholarPubMed
19.Harding, SA, Scheld, WM, McGowan, MD, Sande, MA.Enzyme-linked immunosorbent assay for detection of Streptococcus pneumoniae antigen. J Clin Microbiol 1979; 10: 339–42.CrossRefGoogle ScholarPubMed
20.Sippel, JE, Voller, A.Detection of Neisseria meningitidis cell envelope antigen by enzyme linked immunosorbent assay in patients with meningococcal disease. Trans R Soc Trop Med Hyg 1980; 74: 644–8.CrossRefGoogle ScholarPubMed
21.Sippel, JE, Prato, CM, Girgis, NI, Edwards, EA.Detection of Neisseria meningitidis group A. Haemophilus influenzae type b. and Streptococcus pneumoniae antigens in cerebrospinal fluid specimens by antigen capture enzyme-linked immunosorbent assays. J Clin Microbiol 1984; 20: 259–65.Google Scholar
22.Hassan, MM, Rasoul, AHE.Non-tuberculous meningitis in Sudanese children. Ann Trop Med Hyg 1969; 72: 19–21.Google ScholarPubMed
23.Habte-Gabr, E, Muhe, L, Olcén, P.Rapid etiological diagnosis of pyogenic meningitis by coagglutination, latex agglutination and immunoosmophoresis of cerebrospinal fluid, serum and urine. Trop Geogr Med 1987; 39: 137–43.Google Scholar
24.Sanborn, WR, Toure, IM.A simple kit for rapid diagnosis of cerebrospinal meningitis in rural areas of developing countries. Bull WHO 1984; 62: 293–7.Google ScholarPubMed
25.Ghanassia, JP, Slim, A, Bergogne-Berezin, E, Modai, J.Failure of diagnosing group B meningococcal meningitis by immunoelectroosmophoresis. Scand J Infect Dis 1977; 9: 313–4.CrossRefGoogle Scholar
26.Leinonen, M, Herva, E.The latex agglutination test for the diagnosis of meningococcal and Haemophilus influenzae meningitis. Scand J Infect Dis 1977; 9: 187–91.CrossRefGoogle ScholarPubMed