Latex particle agglutination test in the diagnosis of Haemophilus influenzae type B, Streptococcus pneumoniae and Neisseria meningitidis A and C meningitis in infants and children.
The knowledge of purulent meningitis etiology is essential in deciding the immediate therapy; in developing countries, however, the etiological agent identification does not reach 60% of the cases. A comparative study using the latex particle agglutination test (LPAT) in cerebrospinal fluid (CSF) for the diagnosis of meningitis due to Haemophilus influenzae type b, Streptococcus pneumoniae or Neisseria meningitidis A and C was carried out in Belo Horizonte MG, Brazil. CSF culture was used as a gold-standard. Two hundred and ninety-nine children, ranging from 3 months to 14 years of age, were included in the investigation. One hundred and forty-four presented a positive CSF culture for the above mentioned bacteria; the remaining presented meningitis due to other organisms (other bacteria or viral) or a normal CSF. The sensitivity and the specificity of LPAT was 95.7 and 100.0% for N. meningitidis C, 95.2 and 100.0% for H. influenzae type b and 86.5 and 100.0% for S. pneumoniae, respectively. When all three organisms were considered simultaneously, the sensitivity and the specificity was 93.0 and 100.0%, respectively. Taking into consideration a realistic estimate of disease prevalence in the community where the diagnostic test is being used, the positive predictive value and the posttest probability were estimated as 36.7 and 47.1% for children < 5 years and as 21.3 and 35.1% for children < 14 years of age, respectively. LPAT is a useful diagnostic test for meningitis due to the studied pathogens, especially in developing countries where laboratory facilities are limited.
Camargos
P A
PA
Department of Pediatrics, School of Medicine and Parasitology, Federal University of Minas Gerais, Brazil.
Almeida
M S
MS
Cardoso
I
I
Filho
G L
GL
Filho
D M
DM
Martins
J I
JI
Batista
K W
KW
Silva
R C
RC
Antunes
C M
CM
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007841:Latex Fixation Tests / Q000379:methods*; D008297:Male; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid* / Q000382:microbiology; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid* / Q000382:microbiology; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid* / Q000382:microbiology; D015995:Prevalence; D012680:Sensitivity and Specificity