医療微生物学と診断

Bacterial Paediatric Meningitis Laboratory Diagnosis

Abstract

Gudza-Mugabe M, Robertson V, Mapingure MP, Mtapuri-Zinyowera S and Mavenyengwa RT

Introduction: Bacterial meningitis is one of the top ten causes of death amongst children under 5 years in Zimbabwe. Optimizing the identification of the etiologic agents of bacterial meningitis leads to better management of patients. The objective of this study was to compare the effectiveness of latex agglutination (LA), culture and Polymerase Chain Reaction (PCR) as diagnostic methods in the detection of Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae and Haemophilus influenzae in paediatric cerebral spinal fluids (CSF) specimens at Harare Children`s Hospital (HCH).

Methodology: Specimens from 162 clinically suspected paediatric cases of bacterial meningitis were processed by cell count, Gram stain, culture, latex agglutination and PCR.

Results: Forty-nine (30.2%) suspected cases were positive for at least one of the four bacterial organisms. The latex agglutination test was positive in 33/49 (67.3%) cases, PCR was positive in 37/49 (75.5%) and culture was positive for 17/49 (34.7%) cases. Streptococcus pneumoniae was the predominant pathogen detected in 29 of the 49 positive cases (59.2%) followed by S. agalactiae detected in 11/49 (22.4%) cases. Haemophilus influenzae was detected in 7/49 (14.3%) cases while N. meningitidis accounted for 2/49 (4.1%) positive cases. Thirty-three (20.4%) CSF samples tested positive with the latex agglutination test. This increased the number of organisms above that detected by culture by 16/49 (32.6%). Polymerase chain reaction detected 37 CSF samples increasing the number of organisms detected by culture by 20/49 (40.8%).

Conclusion: Bacterial meningitis mainly caused by Streptococcus pneumoniae is prevalent among children in Zimbabwe and coupling of culture and non-culture methods can improve detection of the disease.