Comparative Analysis of Gram Stain, Culture and Bacterial Antigen Detection in Cerebrospinal Fluid Samples for Laboratory Diagnosis of Acute Bacterial Meningitis in Pediatric Population in A Tertiary Care Hospital

Abstract

Acute bacterial meningitis (ABM) is a life threatening infection in children, associated with long term complications and high mortality rate.1,2 Gram staining and culture are routinely used for diagnosis of ABM. Antigen detection by latex agglutination can provide prompt results thereby facilitating early initiation of empirical antibiotic treatment. To estimate the proportion of Laboratory confirmed cases among children admitted with clinical suspicion of acute bacterial meningitis in a tertiary care hospital. To compare and analyse the diagnostic efficacy of Culture, Gram stain and antigen detection by Latex agglutination in Cerebrospinal fluid (CSF) samples for laboratory detection of Acute bacterial meningitis. CSF samples from pediatric patients with clinical suspicion of ABM were analysed by Gram stain, culture and Antigen detection by Latex agglutination method. Results were recorded and analysed. Of the 50 clinically suspected cases, 13(26%) were confirmed as Acute bacterial meningitis by laboratory investigations. Among the organisms identified, Streptococcus pneumoniae was the most common isolate in 5(38.46%) cases followed by Neisseria meningitidis, Klebsiella pneumoniae and Acinetobacter baumannii in 2(15.38%) cases each and Escherichia coli and Group B Streptococcus in 1(7.69%) case each. Among the confirmed cases, 7(53%) samples showed culture positivity while Gram stain identified 8(61.53%)cases. Latex agglutination test showed positivity in 9(69.23%) cases. In life threatening infections like acute bacterial meningitis, where early diagnosis and prompt treatment is of utmost importance, Latex agglutination test can provide results within minutes facilitating early initiation of empirical therapy, making it an effective adjunct to gram stain and culture.