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An ELISA assay for the rapid diagnosis of acute bacterial meningitis
M A Salih1, A A Ahmed, H Sid Ahmed
1Department of Paediatrics, University of Khartoum, Sudan.
Abstract:
A recently introduced ELISA test (EIA-Test) was used for the detection of the common organisms that cause acute bacterial meningitis (ABM). The test--which detects antigens of Haemophilus influenzae type b, Neisseria meningitidis (serogroups A, B, C) and Streptococcus pneumoniae (25 selected types)--is performed in less than 1 hour and read by the naked eye. Cerebrospinal fluid (CSF) specimens of 125 Sudanese children (1 month-14 years) admitted with a provisional diagnosis of meningitis/meningoencephalitis were prospectively examined with the EIA-Test, direct microscopy (DM) using Gram stain and culture. Of the 56 positive CSF specimens, the EIA-Test had the highest yield (100%), followed by culture (33.9%) and DM (30.4%). Nineteen (33.9%) of the positive samples came from children who had been treated with antibiotics prior to admission, and all were positive in the EIA-Test. EIA-Test was also the only positive test in 31 (55.4%) cases. From the present study, and similar to previous observations, the EIA-Test seems to have valuable potential for the rapid diagnosis of ABM and is of particular help in patients who have been pre-treated with antibiotics.
Insights
A new ELISA test (EIA-Test) accurately detects acute bacterial meningitis (ABM) pathogens in children. This rapid diagnostic tool is especially useful for identifying meningitis in patients pre-treated with antibiotics.
Area of Science:
- Clinical microbiology and infectious diseases
- Diagnostic immunology
Background:
- Acute bacterial meningitis (ABM) is a serious infection requiring rapid diagnosis and treatment.
- Traditional diagnostic methods like culture and microscopy can be slow and have limitations, particularly in patients pre-treated with antibiotics.
Purpose of the Study:
- To evaluate the diagnostic performance of a newly introduced Enzyme Immunoassay (EIA) test for detecting common bacterial meningitis pathogens.
- To assess the utility of the EIA-Test in diagnosing ABM, especially in children who have received prior antibiotic treatment.
Main Methods:
- A prospective study involving 125 Sudanese children diagnosed with meningitis/meningoencephalitis.
- Cerebrospinal fluid (CSF) specimens were analyzed using the EIA-Test, direct microscopy (DM) with Gram stain, and bacterial culture.
- The EIA-Test detects antigens of Haemophilus influenzae type b, Neisseria meningitidis (serogroups A, B, C), and Streptococcus pneumoniae.
Main Results:
- The EIA-Test demonstrated the highest diagnostic yield (100%) among 56 positive CSF specimens.
- Culture and DM had significantly lower yields (33.9% and 30.4%, respectively).
- The EIA-Test correctly identified pathogens in 33.9% of cases with prior antibiotic treatment and was the sole positive test in 55.4% of positive cases.
Conclusions:
- The EIA-Test is a highly sensitive and rapid diagnostic method for acute bacterial meningitis.
- It offers significant advantages over conventional methods, particularly for diagnosing ABM in pre-treated patients.
- The EIA-Test shows considerable potential for improving the timely diagnosis of bacterial meningitis in clinical settings.