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[Etiological diagnosis of suppurative bacterial meningitis today]
Abstract:
As the result of laboratory examination of 2165 patients with virulent bacterial meningitides, including cases of meningococcal infection, the etiological diagnosis was confirmed in 1407 patients (65.0%), the number of cases confirmed by the laboratory examination being significantly greater among adults than among children: 67.5 +/- 1.37% and 63.1 +/- 1.53%, respectively, (t = 2.1). Meningococcal infection was confirmed in 1111 (70.6%) out of 1572 patients under examination. Of the patients with purulent meningitides, pneumococcal etiology was determined in 27.4%, type b of Haemophilus influenzae in 13.5%, other infective agents in 10.0%. The comparison of the results obtained in the examination, carried out by different methods, of 946 children and 770 adults with meningococcal infection revealed a considerable difference in the number of positive results yielded by the bacteriological method and countercurrent immunoelectrophoresis (CIE). Among adults meningococci were isolated twice as frequently (41.1 +/- 2.5% - 19.4 +/- 1.6%), and the results yielded by CIE were predominantly positive (55.1 +/- 2.5% and 40.1 +/- 2.5%). CIE and the immunoenzyme assay were shown to have advantages in the diagnosis of the disease. Under the conditions of intensive antibiotic therapy the methods based on the detection of specific antigens in body fluids can greatly assist in diagnosis.
Insights
Laboratory tests confirmed bacterial meningitis in 65% of 2165 patients. Countercurrent immunoelectrophoresis (CIE) and immunoenzyme assays are advantageous for diagnosing meningococcal infections, especially during antibiotic therapy.
Area of Science:
- Medical microbiology
- Infectious diseases
- Clinical diagnostics
Background:
- Bacterial meningitis remains a significant cause of morbidity and mortality worldwide.
- Accurate and timely etiological diagnosis is crucial for effective treatment and patient outcomes.
- Distinguishing between different causative agents and optimizing diagnostic methods are ongoing challenges.
Purpose of the Study:
- To evaluate the efficacy of laboratory diagnostic methods for bacterial meningitis.
- To compare the performance of bacteriological methods and countercurrent immunoelectrophoresis (CIE) in diagnosing meningococcal infections.
- To assess the utility of antigen detection methods in patients receiving antibiotic therapy.
Main Methods:
- Laboratory examination of 2165 patients with suspected bacterial meningitis.
- Bacteriological culture and countercurrent immunoelectrophoresis (CIE) for etiological diagnosis.
- Comparison of diagnostic yields between different methods and patient age groups.
Main Results:
- Etiological diagnosis was confirmed in 65.0% of patients.
- Meningococcal infection was the most common cause (70.6% of confirmed cases).
- Countercurrent immunoelectrophoresis (CIE) showed higher sensitivity than bacteriological methods for meningococcal detection, particularly in adults.
Conclusions:
- Laboratory diagnostics confirmed bacterial meningitis in a majority of patients, with meningococcal infection being predominant.
- Countercurrent immunoelectrophoresis (CIE) and immunoenzyme assays offer advantages over traditional bacteriology for diagnosing bacterial meningitis.
- Antigen detection methods are valuable diagnostic tools, especially in patients undergoing antibiotic treatment.