Related Experiment Videos
Bacterial counts in cerebrospinal fluid of children with meningitis
E Bingen1, N Lambert-Zechovsky, P Mariani-Kurkdjian
1Department of Microbiology, Hôpital Robert Debré, Paris, France.
Abstract:
Eighty-five cerebrospinal fluid (CSF) specimens from the same number of pediatric patients with meningitis were examined to determine the bacterial count and the relationship of this count to the microscopy results, the ages of the patients and the bacterial species isolated. Bacterial counts ranged from 2 x 10 to 4 x 10(9) CFU/ml CSF. Twenty-five percent of the 85 CSF specimens positive for Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli K1 and group B streptococci had counts of 10(7) CFU/ml or higher. Children between 1 and 6 months of age had significantly higher counts (p less than 0.05) than the other age groups. The three patients who had positive CSF cultures 24 h after the start of therapy all had initial bacterial counts of 10(7) CFU/ml or higher. The detection limit for Gram stain/microscopy was 10(5) CFU/ml. No correlation was found between bacterial count and the number of polymorphonuclear leukocytes.
Insights
High bacterial counts in cerebrospinal fluid (CSF) indicate severe pediatric meningitis. Infants under 6 months with bacterial meningitis often have higher CSF bacterial loads, impacting treatment outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis is a critical pediatric infection.
- Accurate bacterial quantification in cerebrospinal fluid (CSF) is vital for diagnosis and prognosis.
- Understanding the relationship between bacterial load and clinical factors can improve patient management.
Purpose of the Study:
- To determine bacterial counts in CSF of pediatric meningitis patients.
- To investigate the correlation between bacterial load, microscopy results, patient age, and bacterial species.
- To assess the impact of initial bacterial counts on treatment outcomes.
Main Methods:
- Analysis of 85 CSF specimens from pediatric meningitis patients.
- Quantification of bacterial counts (CFU/ml) in CSF.
- Correlation analysis with Gram stain/microscopy, patient age, and bacterial isolates.
- Evaluation of bacterial counts in patients with positive cultures post-therapy.
Main Results:
- Bacterial counts ranged from 2 x 10^3 to 4 x 10^9 CFU/ml.
- 25% of positive CSF specimens had counts ≥ 10^7 CFU/ml.
- Infants aged 1-6 months showed significantly higher bacterial counts (p<0.05).
- Patients with initial counts ≥ 10^7 CFU/ml had positive CSF cultures 24h post-therapy.
- Gram stain/microscopy detection limit was 10^5 CFU/ml.
- No correlation between bacterial count and polymorphonuclear leukocytes.
Conclusions:
- CSF bacterial load is a significant factor in pediatric meningitis.
- Younger infants (1-6 months) present with higher bacterial burdens.
- High initial bacterial counts may predict treatment failure or prolonged infection.
- Microscopy has limitations in detecting lower bacterial loads compared to culture.