title: Incidence of bacterial meningitis in Asia using enhanced CSF testing: polymerase chain reaction, latex agglutination and culture.
abstract: To enhance the detection of bacterial meningitis in an East Asian surveillance study, we employed cerebrospinal fluid (CSF) bacterial culture, latex agglutination (LA) and polymerase chain reaction-enzyme immunoassay (PCR-EIA) testing for Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). The sensitivity and specificity of CSF PCR-EIA testing was compared to LA and culture. A meningitis case was defined by one positive result for any of the three tests. The sensitivity of H. influenzae CSF PCR-EIA, LA, and culture was 100%, 40% and 57.5% respectively; and for Sp CSF PCR-EIA, LA and culture, the sensitivity was 100%, 58.3% and 66.7%, respectively. Hib and Sp specificity was 100% by each method. CSF PCR-EIA was more sensitive than culture or LA for the detection of Hib and Sp meningitis cases increasing their incidence by 74% and 50% compared to culture respectively. CSF PCR-EIA should be included for the detection of bacterial meningitis in surveillance studies.
authors.affiliation: Department of Paediatrics, UCLA School of Medicine and the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, USA. wkennedy@ahs.llumc.edu
authors.forename: W A
authors.initials: WA
authors.lastname: Kennedy
authors.forename: S-J
authors.initials: SJ
authors.lastname: Chang
authors.forename: K
authors.initials: K
authors.lastname: Purdy
authors.forename: T
authors.initials: T
authors.lastname: LE
authors.forename: P E
authors.initials: PE
authors.lastname: Kilgore
authors.forename: J S
authors.initials: JS
authors.lastname: Kim
authors.forename: D D
authors.initials: DD
authors.lastname: Anh
authors.forename: P L T
authors.initials: PL
authors.lastname: Huong
authors.forename: B Q
authors.initials: BQ
authors.lastname: Dong
authors.forename: D M
authors.initials: DM
authors.lastname: Tan
authors.forename: J D
authors.initials: JD
authors.lastname: Clemens
authors.forename: J I
authors.initials: JI
authors.lastname: Ward
mesh_terms: D001208:Asia; D001431:Bacteriological Techniques; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D002675:Child, Preschool; D015169:Colony Count, Microbial; D005260:Female; D019741:Haemophilus influenzae type b / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D007841:Latex Fixation Tests; D008297:Male; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid*; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000302:isolation & purification