Correlation of cerebrospinal fluid endotoxinlike activity with clinical and laboratory variables in gram-negative bacterial meningitis in children
| Autor: | L M Dunkle, L Blair, T L Dwelle |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Screening test Meningitis Meningococcal Neutropenia Biology Gastroenterology Microbiology Gram-negative bacterial meningitis Cerebrospinal fluid Predictive Value of Tests Internal medicine Gram-Negative Bacteria medicine Humans Meningitis Pseudomonas Infections Prospective Studies Escherichia coli Infections Limulus Test Meningitis Haemophilus Infant Newborn Infant Bacterial Infections medicine.disease Predictive value Endotoxins Present illness Limulus amebocyte lysate Bacterial meningitis Research Article |
| Zdroj: | Journal of Clinical Microbiology. 25:856-858 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.25.5.856-858.1987 |
| Popis: | Detection of endotoxinlike activity in cerebrospinal fluid by Limulus amebocyte lysate gelation has been suggested as a useful technique for the diagnosis of gram-negative bacterial meningitis. We prospectively screened 1,503 cerebrospinal fluid specimens with a Limulus amebocyte lysate microassay. The limit of sensitivity of the assay was 0.01 ng/ml. All specimens that were positive for endotoxinlike activity were subjected to confirmatory retesting, after which 38 (86%) remained positive. Comparison with available culture results revealed that 33 of 38 specimens (86%) were culture positive; 3 of the 5 culture-negative specimens were from patients on therapy for gram-negative bacterial meningitis, and 1 was from a neonate. The overall specificity of confirmed positive tests was 99.5%, with a positive predictive value of 97.3%. There was one false-negative specimen, giving an overall sensitivity of 97.3% and a negative predictive value of 99.9%. Endotoxinlike activities of greater than or equal to 150 ng/ml correlated with present illness of less than 2 days' duration (P = 0.024), elevated cerebrospinal fluid protein (P less than 0.05), and seizures (P = 0.004); levels of greater than or equal to 3,000 ng/ml correlated with neutropenia (P = 0.032), and levels of greater than or equal to 3.2 X 10(6) ng/ml correlated with death (P = 0.001). We conclude that the Limulus amebocyte lysate microslide gelation test has prognostic value as a sensitive, specific, simple, inexpensive screening test for gram-negative bacterial meningitis. |
| Databáze: | OpenAIRE |
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