STUDY OF ACUTE BACTERIAL MENINGITIS IN CHILDREN BY GRAM STAIN, CULTURE AND ANTIGEN DETECTION
DOI:
https://doi.org/10.22159/ijcpr.2024v16i2.4029Keywords:
Acute bacterial meningitis, Antigen detection, Culture, Gram stainAbstract
Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection.
Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit.
Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin.
Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.
Downloads
References
Sallam AK. Etiology and presentation of acute bacterial meningitis in children at Al-Thawrah Hospital, Sana’a, Yemen. J Ayub Med Coll Abbottabad. 2004 Oct-Dec;16(4):40-3. PMID 15762062.
Mantese OC, Hirano J, Santos IC, Silva VM, de Castro ED. Etiological profile of bacterial meningitis in children. J Pediatr (Rio J). 2002;78(6):467-74. doi: 10.2223/JPED.901, PMID 14647726.
Garg A, Sharma A, Kumari S, Shandil A. Clinical profile and outcome of pediatric bacterial meningitis: a prospective study from tertiary institute in Northern India. Int J Res Med Sci. 2018;6(8):2739-45. doi: 10.18203/2320-6012.ijrms20183261.
Viswanath G, Praveen, Hanumanthappa AR, Chandrappa NR, Mahesh CB. Bacteriological study of pyogenic meningitis with special reference to latex agglutination. Indian J Pathol Microbiol. 2007;50(1):97-100. PMID 17474275.
Mani R, Pradhan S, Nagarathna S, Wasiulla R, Chandramuki A. Bacteriological profile of community-acquired acute bacterial meningitis: a ten-year retrospective study in a tertiary neurocare centre in South India. Indian J Med Microbiol. 2007;25(2):108-14. doi: 10.1016/S0255-0857(21)02167-8.
Surinder K, Bineeta K, Megha M. Latex particle agglutination test as an adjunct to the diagnosis of bacterial meningitis. Indian J Med Microbiol. 2007;25(4):395-7. doi: 10.4103/0255-0857.37347, PMID 18087093.
Geneva Switzerland Geneva. Bacterial meningitis. WHO Recommended standards for surveillance of selected vaccine-preventable diseases. WHO/V and B/03.01: vaccine assessment and monitoring team of the department of vaccines and biologicals. WHO; 2003. p. 4-6.
Mirdha BR, Gupta U, Bhujwala RA. Latex agglutination test: an adjunct to the laboratory diagnosis of pyogenic bacterial meningitis. Indian J Pediatr. 1991;58(4):521-4. doi: 10.1007/BF02750934, PMID 1800334.
Gaurav B, Patel Komal D, Soni Sumeeta T, Patel Kanu J, MangukiyaJayasukh D, Jain Pooja S. Bacteriological profile of pyogenic meningitis in Tertiary Care Hospital, Ahemadbad. Natl J Med Res. 2012;2(3)313-7.
Jagadevi, Jagadeesh, Anjana Gopi. Diagnostic utility of latex agglutination test and antibiogram of isolates causing acute bacterial meningitis in pediatric age group. RJPBCS. Jan-Feb 2014;5(1):1005-13.
Sayedafasihamohammadi Asha B Patil, Shoba D Nadagir, Namratha Nandihal SA Lakshminarayana. Diagnostic value of latex agglutination test in the diagnosis of acute bacterial meningitis. Ann Indian Acad Neurol. 2013 Oct-Dec;16(4):645-9.
Washburn TC, Medearis DN, Childs B. Sex differences in susceptibility to infections. Pediatrics. 1965;35:57-64. doi: 10.1542/peds.35.1.57, PMID 14223226.
Chinchankar N, Mane M, Bhave S, Bapat S, Bavdekar A, Pandit A. Diagnosis and outcome of acute bacterial meningitis in early childhood. Indian Pediatr. 2002;39(10):914-21. PMID 12428036.
Saez Lorens Xavier, George H, McCraken Jr. Infectious disease of children. 11th ed. St Louis: Mosby publications; 2004.
Mishra B, Mahaseth C, Rayamajhi A. Latex agglutination test for early detection of the causative organism in acute bacterial meningitis. Journal of Nepal Paediatric Society. 2013;33(1):34-8. doi 10.3126/jnps.v33i1.7047.
Shilpa Dayan, Putta, Smita Deshpande, Renu Bharadwaj. Evaluation of latex agglutination test. Efficacy in diagnosis of acute pyogenic meningitis. Latex Agglutination Test in Acute Pyogenic Meningitis. 2016;3(4):A270-A275.
Shiva Prakash MR, Rajagopal V, Nagarathna S. Latex agglutination test in the diagnosis and outcome of acute bacterial meningitis in early childhood. India Npediatric. 2002;39:914-92.
Gray Larry D, Fedorko Daniel P. Laboratory diagnosis of bacterial meningitis. Clin Microbiol Rev. 1992 Apr;5(2):130-45. doi: 10.1128/CMR.5.2.130, PMID 1576585.
Jyothi R, Ramani Bai J. Utility of latex agglutination test (LAT) in detecting acute bacterial meningitis against culture as gold standard. J Acad Clin Microbiol. 2015;17(2):84. doi: 10.4103/0972-1282.171888.
Das BK, Gurubacharya RL, Mohapatra TM, Mishra OP. Bacterial antigen detection test in Meningitis. Indian J Pediatr. 2003;70(10):799-801. doi: 10.1007/BF02723800, PMID 14649475.
Published
How to Cite
Issue
Section
Copyright (c) 2024 KOSANAM RAMYASRI, GUNTI RAJYALAKSHMI, ARAVADURGA RANI, MURTHY DS
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.