title: Cerebrospinal fluid lens-free microscopy: a new tool for the laboratory diagnosis of meningitis.
abstract: Cerebrospinal fluid cytology is performed by operator-dependant light microscopy as part of the routine laboratory work-flow diagnosis of meningitis. We evaluated operator-independent lens-free microscopy numeration of erythrocytes and leukocytes for the cytological diagnosis of meningitis. In a first step, prospective optical microscopy counts of leukocytes done by five different operators yielded an overall 16.7% misclassification of 72 cerebrospinal fluid specimens in meningitis/non-meningitis categories using a 10 leukocyte/μL cut-off. In a second step, the lens-free microscopy algorithm adapted for counting cerebrospinal fluid cells and discriminating leukocytes from erythrocytes was modified step-by-step in the prospective analysis of 215 cerebrospinal fluid specimens. The definite algorithm yielded a 100% sensitivity and a 86% specificity compared to confirmed diagnostics. In a third step, a blind lens-free microscopic analysis of 116 cerebrospinal fluid specimens, including six cases of microbiology-confirmed infectious meningitis, yielded a 100% sensitivity and a 79% specificity. Adapted lens-free microscopy is thus emerging as an operator-independent technique for the rapid numeration of leukocytes and erythrocytes in cerebrospinal fluid. In particular, this technique is well suited to the rapid diagnosis of meningitis at point-of-care laboratories.
authors.affiliation: Aix Marseille Univ, INSERM, CNRS, IRD, URMITE, Marseille, France.
authors.forename: Robin
authors.initials: R
authors.lastname: Delacroix
authors.affiliation: Université de Grenoble Alpes, F-38000 Grenoble, France, CEA, LETI, MINATEC Campus, Technologies for Healthcare and Biology division, F-38054 Grenoble, France.
authors.forename: Sophie Nhu An
authors.initials: SN
authors.lastname: Morel
authors.affiliation: Université de Grenoble Alpes, F-38000 Grenoble, France, CEA, LETI, MINATEC Campus, Technologies for Healthcare and Biology division, F-38054 Grenoble, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Hervé
authors.affiliation: Université de Grenoble Alpes, F-38000 Grenoble, France, CEA, LETI, MINATEC Campus, Technologies for Healthcare and Biology division, F-38054 Grenoble, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bordy
authors.affiliation: Université de Grenoble Alpes, F-38000 Grenoble, France, CEA, LETI, MINATEC Campus, Technologies for Healthcare and Biology division, F-38054 Grenoble, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Dinten
authors.affiliation: Aix Marseille Univ, INSERM, CNRS, IRD, URMITE, Marseille, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
authors.affiliation: Université de Grenoble Alpes, F-38000 Grenoble, France, CEA, LETI, MINATEC Campus, Technologies for Healthcare and Biology division, F-38054 Grenoble, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Allier
mesh_terms: D002555:Cerebrospinal Fluid / Q000166:cytology*; D003581:Cytodiagnosis / Q000379:methods / Q000592:standards; D004912:Erythrocytes / Q000166:cytology; D006801:Humans; D007962:Leukocytes / Q000166:cytology; D008581:Meningitis / Q000134:cerebrospinal fluid*; D015588:Observer Variation; D000067716:Point-of-Care Testing / Q000592:standards*