Accuracy of cerebrospinal leucocyte count, protein and culture for the diagnosis of acute bacterial meningitis: a comparative study using B ayesian latent class analysis

Objective To examine the utility of laboratory methods other than bacterial culture in diagnosing acute bacterial meningitis ( ABM ). Methods Bayesian latent class analysis was used to estimate diagnostic precision of cerebrospinal fluid ( CSF ) culture, leucocyte counts and protein concentrations for ABM in M elanesian children. Results With a cut‐off of ≥20 leucocytes/mm 3 , the area under the receiver operating characteristic curve ( AUC ROC ) was >97.5% for leucocyte counts. A lower (93%) AUC ROC was observed for CSF protein concentrations ≥1 g/l. CSF culture had poor sensitivity and high specificity. Conclusion Leucocyte counts provide sufficient diagnostic precision to aid clinical decision‐making in ABM .