title: Handheld point-of-care cerebrospinal fluid lactate testing predicts bacterial meningitis in Uganda.
abstract: We validated a handheld point-of-care lactate (POCL) monitor's ability to measure lactate in cerebrospinal fluid (CSF) and diagnose bacterial meningitis in Uganda. There was a strong linear correspondence between POCL and standard laboratory lactate test results (R(2) = 0.86; P < 0.001). For 145 patients with clinical meningitis, the area under the receiver operating characteristic curve for the prediction of bacterial meningitis by CSF POCL was 0.92 (95% confidence interval = 0.85-0.99, P < 0.001). A CSF POCL concentration of 7.7 mmol/L provided 88% sensitivity and 90% specificity for the diagnosis of bacterial meningitis. CSF POCL testing had excellent use in the diagnosis of bacterial meningitis, and it may be useful where CSF analyses are delayed or laboratory infrastructure is limited.
authors.affiliation: Department of Internal Medicine, Mbarara Regional Referral Hospital, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. majalb2k@yahoo.com
authors.forename: Albert
authors.initials: A
authors.lastname: Majwala
authors.forename: Rebecca
authors.initials: R
authors.lastname: Burke
authors.forename: William
authors.initials: W
authors.lastname: Patterson
authors.forename: Relana
authors.initials: R
authors.lastname: Pinkerton
authors.forename: Conrad
authors.initials: C
authors.lastname: Muzoora
authors.forename: L Anthony
authors.initials: LA
authors.lastname: Wilson
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Moore
mesh_terms: D006801:Humans; D019344:Lactic Acid / Q000134:cerebrospinal fluid*; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D019095:Point-of-Care Systems; D014454:Uganda
chemical_list: D019344:Lactic Acid