title: Accuracy of cerebrospinal leucocyte count, protein and culture for the diagnosis of acute bacterial meningitis: a comparative study using Bayesian latent class analysis.
abstract: OBJECTIVE
  To examine the utility of laboratory methods other than bacterial culture in diagnosing acute bacterial meningitis (ABM).
  
  
  METHODS
  Bayesian latent class analysis was used to estimate diagnostic precision of cerebrospinal fluid (CSF) culture, leucocyte counts and protein concentrations for ABM in Melanesian children.
  
  
  RESULTS
  With a cut-off of ≥20 leucocytes/mm(3) , the area under the receiver operating characteristic curve (AUC ROC) was >97.5% for leucocyte counts. A lower (93%) AUC ROC was observed for CSF protein concentrations ≥1 g/l. CSF culture had poor sensitivity and high specificity.
  
  
  CONCLUSIONS
  Leucocyte counts provide sufficient diagnostic precision to aid clinical decision-making in ABM.
authors.affiliation: School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Fremantle, WA, Australia.
authors.forename: Laurens
authors.initials: L
authors.lastname: Manning
authors.forename: Moses
authors.initials: M
authors.lastname: Laman
authors.forename: Trevor
authors.initials: T
authors.lastname: Mare
authors.forename: Ilomo
authors.initials: I
authors.lastname: Hwaiwhanje
authors.forename: Peter
authors.initials: P
authors.lastname: Siba
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D019540:Area Under Curve; D001419:Bacteria; D001499:Bayes Theorem; D002452:Cell Count; D002555:Cerebrospinal Fluid / Q000276:immunology / Q000378:metabolism; D002556:Cerebrospinal Fluid Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D010219:Papua New Guinea; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D002556:Cerebrospinal Fluid Proteins
keywords: Bayesian latent class analysis; Papouasie-Nouvelle-Guinée; Papua New Guinea; Papúa New Guinea; acute bacterial meningitis; analyse de structure latente bayésienne; análisis Bayesiano de clase latente; cerebrospinal fluid; liquide céphalo-rachidien; líquido cefalorraquídeo; meningitis bacteriana aguda; méningite bactérienne aiguë