IMMUNOFLUORESCENCE IN THE DIAGNOSIS OF ACUTE BACTERIAL MENINGITIS: A COOPERATIVE EVALUATION OF THE TECHNIQUE IN A CLINICAL LABORATORY SETTING

Abstract

Previous workers have described the application of immunofluorescent techniques as a research tool for the identification of the organisms commonly causing acute bacterial meningitis. In this report the evaluation of the fluorescent anti-body (FA) technique in a clinical setting is described. Cerebrospinal fluid (CSF) specimens from 287 patients with acute bacterial meningitis were examined in the routine hospital laboratory by culture, Gram stain, and the FA test. Polyvalent FA reagents as well as group, pool, and type specific reagents for Neisseria meningitidis, Diplococous pneumoniae, and Hemophilus influenzae, respectively, were used in this study. There was no statistically significant difference in the overall number of positive identifications made with each of the three tests (culture, Cram stain, and FA). The FA test provided an immunologically specific identification within one hour of receipt of the CSF specimen and was an accurate method for testing CSF's from patients who had been partially treated with antimicrobial agents. The FA test also was useful in the examination of spinal fluids containing scant numbers of organisms. Examination of spinal fluid by the FA technique appears to be a valuable adjunct in the rapid, specific identification of the three bacterial species commonly causing acute bacterial meningitis.