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Accuracy of antigen tests for meningococcal meningitis in cerebrospinal fluid: A diagnostic meta-analysis

Hsiu-Ling Lin1, Hui-Mei Chen1, Chih-Yen Lin2

  • 1Department of Nursing, Landseed International Hospital, Taoyuan, Taiwan.

Tropical Medicine & International Health : TM & IH
|August 29, 2023
PubMed
Abstract

Insights

Antigen tests demonstrate high accuracy for diagnosing Neisseria meningitidis in cerebrospinal fluid, offering a reliable method for identifying invasive meningococcal disease in children. These tests provide timely and convenient results for suspected infections.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Neisseria meningitidis is a primary cause of childhood meningitis and invasive meningococcal disease (IMD).
  • Accurate and timely diagnosis of IMD is crucial for effective treatment and patient outcomes.
  • While cerebrospinal fluid (CSF) identification is standard, antigen tests offer practical advantages.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of antigen tests for Neisseria meningitidis in CSF samples.
  • To determine the pooled sensitivity and specificity of these antigen tests.

Main Methods:

  • A systematic meta-analysis was conducted, searching PubMed, Embase, and Cochrane Library databases.
  • Included studies provided data for 2x2 tables on a per-sample basis.
  • Polymerase chain reaction (PCR) served as the reference standard, analyzed using a hierarchical summary receiver operating characteristic model.

Main Results:

  • Nine studies comprising 4533 CSF samples were analyzed.
  • The overall pooled sensitivity was 91.2% (95% CI: 80.0%-100.0%) and specificity was 93.8% (95% CI: 83.9%-100.0%).
  • Subgroup analysis for MeningoSpeed showed 93.4% sensitivity and 91.9% specificity; for serogroup X, sensitivity was 92.4% and specificity was 99.2%.

Conclusions:

  • The evaluated antigen tests exhibit high sensitivity and specificity for diagnosing meningococcal meningitis.
  • Antigen testing represents an accurate and valuable diagnostic tool for suspected Neisseria meningitidis infections.
  • These findings support the utility of antigen tests in clinical settings for IMD diagnosis.
Keywords:
antigen testcerebrospinal fluidmeningococcal infectionsmeningococcal meningitismeta-analysis

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