Invasive meningococcal disease and latex agglutination test--is it still beneficial for diagnosis?
We showed current clinical usefulness of the latex agglutination (LA) test for confirmation of meningococcal etiology on 32 cerebrospinal fluid, 77 serum and 93 urine samples collected during the first week of hospitalization from 19 patients with laboratory confirmed invasive meningococcal disease. The positivity of the LA test in cerebrospinal fluid was 47%, in serum 42% and in urine 24%, while the PCR of cerebrospinal fluid and serum was positive in 95 and 47% cases, respectively. The latest positivity of the LA test was detected on day 2 in cerebrospinal fluid, on day 3 in serum and on day 4 in urine. In the group of patients who had received antibiotic therapy we found nonsignificant reduction of LA positivity and also statistically significant reduction of culture positivity in CSF (p = 0.04); the PCR positivity changed minimally. In blood samples, nonsignificant reduction of culture positivity and no difference in LA and PCR positivity was found. We did not find any statistically significant relationship between test results and clinical forms. The LA test can be therefore considered to be an auxiliary diagnostic method, rapid and easily practicable but less sensitive than PCR. It can be recommended especially for local laboratories where PCR is not available and the patient already received antibiotics before admission to the hospital.
Department of Infectious Diseases, 2nd Medical Faculty of Charles University, Prague, Czechia. e.bronska@seznam.cz
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Bronská
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Dzupová
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Krízová
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Kalmusová
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V
Maresová
D000293:Adolescent; D000328:Adult; D002555:Cerebrospinal Fluid / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007223:Infant; D007841:Latex Fixation Tests; D008297:Male; D008585:Meningitis, Meningococcal / Q000175:diagnosis*; D008589:Meningococcal Infections / Q000175:diagnosis*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000235:genetics / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D044967:Serum / Q000382:microbiology; D014556:Urine / Q000382:microbiology
D004269:DNA, Bacterial