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Accuracy of cerebrospinal leucocyte count, protein and culture for the diagnosis of acute bacterial meningitis: a comparative study using B ayesian latent class analysis
Author(s) -
Manning Laurens,
Laman Moses,
Mare Trevor,
Hwaiwhanje Ilomo,
Siba Peter,
Davis Timothy M. E.
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12400
Subject(s) - cerebrospinal fluid , meningitis , receiver operating characteristic , medicine , bacterial meningitis , microbiological culture , immunology , latent class model , diagnostic accuracy , gastroenterology , biology , surgery , bacteria , statistics , mathematics , genetics
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 .