Sapporo Medical Journal

Abstract : Bacterial meningitis is a life-threatening medical emergency. Cerebrospinal fluid (CSF) culture is a must to identify the pathogens of bacterial meningitis. Still, its result is usually late and sometimes shows low sensitivity, especially due to antibiotics previously given. Latex agglutination test and Gram staining are not sufficiently sensitive. Multiplex real-time PCR assay gives quick diagnostic results with high sensitivity, even with non-viable bacterial agents. The study aimed to evaluate the validity of the combination of different assays in diagnosing bacterial meningitis in Vietnamese children. A cross-sectional study was conducted. CSF culture, latex agglutination test, Gram staining, and multiplex real-time PCR assays were performed. The Kappa statistic was used to calculate the agreement between the methods. Totally, 108 eligible cases were recruited. There were five positive cases (4.6%) isolated by CSF culture, while the multiplex real-time PCR assays identified pathogens in four cases (3.7%). Latex agglutination testing and Gram staining gave positive signals in three different cases. The agreement between multiplex real-time PCR and culture / latex agglutination testing / Gram staining was 0.652 / 0.852 / 0.262 correspondingly by the kappa statistics. The study showed that different diagnostic methods should be used to give accurate results in the determination of infectious agents in CSF specimens causing acute bacterial meningitis in Vietnamese children.