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Rapid diagnosis of bacterial meningitis using nitrite patch testing.

C Maclennan¹, E Banda, E M Molyneux

¹Department of Paediatrics, College of Medicine, Box 360, Blantyre, Malawi.

Tropical Doctor

|October 30, 2004

Summary

Urine reagent test strips can detect bacterial meningitis in cerebrospinal fluid (CSF) when lab facilities are unavailable. The nitrite patch offers a cost-effective diagnostic aid for bacterial meningitis in children.

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Area of Science:

Clinical diagnostics
Microbiology
Pediatrics

Background:

Cerebrospinal fluid (CSF) analysis is crucial for diagnosing meningitis.
Urine reagent strips are utilized for CSF testing in resource-limited settings.
Protein, glucose, and leukocyte esterase on strips have demonstrated utility in CSF analysis.

Purpose of the Study:

To evaluate the diagnostic utility of the nitrite patch on urine reagent strips for detecting bacterial meningitis in pediatric CSF samples.
To assess the cost-effectiveness of incorporating nitrite patch testing into CSF analysis.

Main Methods:

CSF samples from 200 children with suspected meningitis were tested.
Laboratory diagnoses were dichotomized into 'bacterial meningitis' or 'not bacterial meningitis'.

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Nitrite patch results (positive/negative) were compared against final diagnoses.

Main Results:

Nitrite patch testing demonstrated significant diagnostic value.
Positive likelihood ratios were 49 for all CSF, 'infinity' for clear CSF, and 5.8 for bloody CSF.
The nitrite patch provides clinically useful information at no additional cost.

Conclusions:

The nitrite patch is a valuable, inexpensive tool for diagnosing bacterial meningitis using CSF.
This method can aid clinical decision-making, particularly in settings lacking advanced laboratory facilities.
Further research can explore its integration into routine diagnostic protocols for suspected meningitis.