Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Indian Journal of Pediatrics
Published in: Indian Journal of Pediatrics 4/2015

01-04-2015 | Original Article

The Role and Reliability of Rapid Bedside Diagnostic Test in Early Diagnosis and Treatment of Bacterial Meningitis

Authors: Arun Kumar, Pradeep Kumar Debata, Amitabh Ranjan, Rajani Gaind

Published in: Indian Journal of Pediatrics | Issue 4/2015

Login to get access

Abstract

Objective

To evaluate the role and reliability of rapid bedside diagnostic test in early diagnosis and treatment of bacterial meningitis in children using reagent strips.

Methods

This prospective, single blinded study was conducted in the Department of Pediatrics of VMMC & Safdarjung Hospital, New Delhi in collaboration with the Department of Microbiology of VMMC & Safdarjung Hospital, New Delhi, over a period of 15 mo (August 2009 to Nov 2010). Seventy-five children aged 3 mo to 12 y admitted in the pediatric ward with suspected diagnosis of acute meningitis were included. All enroled patients underwent lumbar puncture. CSF samples were taken and divided in 2 parts for laboratory evaluation and rapid strip analysis. The sensitivity, specificity, positive predictive value and the negative predictive values of the reagent strips for the diagnosis of bacterial meningitis were calculated. Accuracy of the reagent strips was established using kappa statistics. Latex agglutination for antigen detection and microbiological culture were also done.

Results

Highly significant association was observed between CSF examination in routine laboratory method and dipstick method. The number of laboratory values that correlated were- for cells 71(94.63 %), for protein 68 (90.67 %), for glucose 68(90.67 %) out of total 75 cases. The sensitivity and specificity of reagent strip in diagnosing acute bacterial meningitis were 96.7 % and 97.8 % respectively. The positive predictive and negative predictive values of reagent strip in diagnosing acute bacterial meningitis were 96.7 % and 97.8 % respectively. Staphylococcus aureus was found to be the most common organism isolated (50 %).

Conclusions

Thus reagent strip analysis is a very rapid, reliable and effective method for diagnosis of acute bacterial meningitis in children. Staphylococcus aureus was the most common organism isolated.
Literature
1.
Aronin SI, Peduzzi P, Quagliarello VJ. Community-acquired bacterial meningitis: Risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med. 1998;129:862–9.CrossRefPubMed
2.
Modi GB, Patel KD, Soni ST, Patel KJ, Mangukiya JD, Jain PS. Bacteriological profile of pyogenic meningitis in tertiary care hospital, Ahmedabad. Natl J Med Res. 2012;2:313–7.
3.
4.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84.CrossRefPubMed
5.
Proulx N, Fréchette D, Toye B, Chan J, Kravcik S. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. QJM. 2005;98:291–8.CrossRefPubMed
6.
Miner JR, Heegaard W, Mapes A, Biros M. Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. Emerg Med. 2001;21:387–92.CrossRef
7.
Trampuz A, Steinhuber A, Wittwer M, Leib SL. Rapid diagnosis of experimental meningitis by bacterial heat production in cerebrospinal fluid. BMC Infect Dis. 2007;7:116.CrossRefPubMedCentralPubMed
8.
Kim DW, Kilgore PE, Kim EJ, Kim SA, Anh DD, Seki M. Loop-mediated isothermal amplification assay for detection of haemophilus influenzae type b in cerebrospinal fluid. J Clin Microbiol. 2011;49:3621–6.CrossRefPubMedCentralPubMed
9.
Moosa AA, Quortum HA, Ibrahim MD. Rapid diagnosis of bacterial meningitis with reagent strips. Lancet. 1995;345:1290–1.CrossRefPubMed
10.
Parmar R, Warke S, Sira P, Kamat JR. Rapid diagnosis of meningitis using reagent strips. Indian J Med Sci. 2004;58:62–6.PubMed
11.
Romanelli R, Thome EE, Duarte FMC, Gomes RS, Camargos PA, Freire HB. Diagnosis of meningitis with reagent strips. J Pediatr (Rio J). 2001;77:203–8.CrossRef
12.
Singh H, Sarkar R, Saini L, Sachdev HPS. Immunological test in acute bacterial meningitis. Indian Pediatr. 1988;25:323–8.PubMed
13.
Chinchankar N, Mane M, Bhave S, Bapat S, Bavdekar A, Pandit A, et al. Diagnosis and outcome of acute bacterial meningitis in early childhood. Indian Pediatr. 2002;39:914–21.PubMed
14.
Mulu A, Kassu A, Tessema B. Bacterial isolates from cerebrospinal fluids and their antibiotic susceptibility patterns in Gondar University Teaching Hospital, Northwest Ethiopia. Ethiop J Health Dev. 2005;19:160–4.CrossRef
15.
Bareja R, Pottathil S, Shah RK, Grover PS, Singh VA. Trends in bacterial etiology amongst cases of meningitis. J Acad Indus Res. 2013;1:761–5.
16.
Sahai S, Mhadevan S, Srinivasan S, Kanungo R. Childhood bacterial meningitis in Pondicherry, South India. Indian J Pediatr. 2001;68:839–41.CrossRefPubMed
Metadata
Title
The Role and Reliability of Rapid Bedside Diagnostic Test in Early Diagnosis and Treatment of Bacterial Meningitis
Authors
Arun Kumar
Pradeep Kumar Debata
Amitabh Ranjan
Rajani Gaind
Publication date
01-04-2015
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 4/2015
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-014-1357-z

Other articles of this Issue 4/2015

Indian Journal of Pediatrics 4/2015 Go to the issue

Erratum

Erratum to: Neonatal Research in India: Current Status, Challenges, and the Way Forward

Scientific Letter

Two Brothers with Multiple Cranial Nerve Palsies

Review Article

Childhood Tuberculosis in General Practice

Original Article

Effectiveness of a School Based Intervention for Prevention of Non-communicable Diseases in Middle School Children of Rural North India: A Randomized Controlled Trial

Original Article

Meningitis Related Ventriculitis - Experience from a Tertiary Care Centre in Northern India

Editorial Commentary

Acute Bacterial Meningitis – Early Diagnosis and Complications