Predictive performance of cerebrospinal fluid parameters for diagnosis of meningitis in infants: a cohort study

医学 脑脊液 脑膜炎 队列 队列研究 儿科 细菌性脑膜炎 脑脊液白蛋白 内科学
作者
Christine M. O'Leary,Laure F. Pittet,Rachael Beaumont,Laura Constable,Andrew J. Daley,Isabelle Hodge,Susan E Jacobs,Arrabella King,Catherine Tan,Nigel Curtis,Amanda Gwee
出处
期刊:Archives of Disease in Childhood [BMJ]
卷期号:: archdischild-327628
标识
DOI:10.1136/archdischild-2024-327628
摘要

Background The gold standard for diagnosis of meningitis is the isolation of a pathogen from cerebrospinal fluid (CSF) by culture or PCR. However, treatment is routinely commenced based on CSF findings prior to microbiological results. This study determined the predictive value of CSF parameters for diagnosing bacterial and viral meningitis in young infants. Methods Multicentre retrospective (2010–2020) cohort study of 1088 CSF results from infants aged 0–90 days. The predictive value of CSF parameters (white blood cell count (WCC), neutrophil, protein, glucose) was evaluated in 538 meningitis cases (39 bacterial, 499 viral) compared with controls with negative CSF microbiological testing and no prior antibiotics. Results For bacterial meningitis, the sensitivity of the commonly used CSF WCC cut-off of 20×10 6 /L for neonates, 15×10 6 /L for infants 1–2 months old and 5×10 6 /L for infants 2–3 months old was 89%, 91% and 86% and the specificity was 78%, 77% and 61%, respectively. CSF protein levels ≥1 g/L in neonates and ≥0.8 g/L in infants aged 1–3 month, or CSF neutrophils ≥2×10 6 /L, independently increased the likelihood of bacterial meningitis (positive likelihood ratios ≥5 and ≥3, respectively). 3 of 39 cases of bacterial meningitis would have been missed using the commonly used WCC cut-offs alone. However, two would have been identified using CSF protein and neutrophil thresholds. All CSF parameters were poor at identifying viral meningitis. Conclusion A single CSF parameter cannot reliably diagnose bacterial meningitis. For identification of bacterial meningitis, elevation of CSF WCC, neutrophil count or protein levels above threshold values improves accuracy of diagnosis.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
沙不凡完成签到,获得积分20
刚刚
1秒前
马里奥爱科研完成签到,获得积分10
1秒前
新晋学术小生完成签到 ,获得积分10
1秒前
2秒前
bkagyin应助chen采纳,获得10
3秒前
Tttttttt完成签到,获得积分10
4秒前
5秒前
WX发布了新的文献求助10
6秒前
斯文败类应助书祝采纳,获得30
10秒前
黄志敏发布了新的文献求助10
10秒前
XXX发布了新的文献求助30
10秒前
11秒前
Shandongdaxiu发布了新的文献求助10
11秒前
华仔应助wsh采纳,获得10
11秒前
11秒前
我要赶快毕业完成签到,获得积分10
11秒前
不安的夜柳完成签到,获得积分10
12秒前
cctv18应助天水碧采纳,获得10
13秒前
14秒前
14秒前
14秒前
周周发布了新的文献求助10
15秒前
ALBRAHEEIBRAHIM完成签到,获得积分20
16秒前
17秒前
18秒前
18秒前
19秒前
等待世平完成签到,获得积分10
19秒前
ambition6669发布了新的文献求助10
19秒前
希望天下0贩的0应助cli采纳,获得10
21秒前
22秒前
22秒前
22秒前
24秒前
一生所爱完成签到,获得积分10
24秒前
华仔应助黄志敏采纳,获得10
24秒前
ambition6669完成签到,获得积分10
25秒前
luxlili发布了新的文献求助10
26秒前
帕尔发布了新的文献求助10
26秒前
高分求助中
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 799
草地生态学 500
Retention of title in secured transactions law from a creditor's perspective: A comparative analysis of selected (non-)functional approaches 500
"Sixth plenary session of the Eighth Central Committee of the Communist Party of China" 400
Introduction to Modern Controls, with illustrations in MATLAB and Python 310
PROJECT STUDIES; -A LATE MODERN UNIVERSITY REFORM? 300
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3057772
求助须知:如何正确求助?哪些是违规求助? 2714072
关于积分的说明 7439066
捐赠科研通 2359232
什么是DOI,文献DOI怎么找? 1249940
科研通“疑难数据库(出版商)”最低求助积分说明 607315
版权声明 596334