Keywords
meningitis, bacterial, laboratorial diagnosis
How to Cite
1.
Melles CEA, Landgraf IM, Faraco ML, Boscardin NB. Bacterioscopy, culture and counterimmunoelectrophoresis (IEC) values in the diagnosis of bacterial meningitis. Rev Inst Adolfo Lutz [Internet]. 1989 Jun. 30 [cited 2024 May 20];49(1):61-7. Available from: https://periodicos.saude.sp.gov.br/RIAL/article/view/36933
Abstract
In a post-epidemic period of bacterial meningitis, a comparative study by means of bacterioscopic analysis, culture and ounterimmunoelectroforesis (C.I.E.) of cerebrospinal fluid (C.S.F.) the three most frequent bacterias were Neisseria Meningitidis, Streptococcus pneumoniae and Haemophilus influenzae. From 326 cases considered, the bacterioscopic analysis was positive in 273 of them (83.74%), C.I.E. in 273 (83.74%) and culture in 207 (63.50%). In the total of the samples, the number of cases identified by bacterioscopic observation and by C.LE. was just the same (p< 0,05) but when the three methods were compared in association the positiviy of the bacterioscopic analysis was higher (95.33%) than C.I.E. (95.05%) and than culture (77.04%) (p<0,05). C.I.E. is the most important diagnostic tool, chiefly when the usefulness of the other tests in CSF is not reliable, because of some technical reasons. None of these methods should be employed alone; therefore, when they are amployed all together they may lead to a best diagnosis, that means to avoid interpretation error, and the best quality control for the diagnostic tools.
References
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tes grupos de Neisseria meningitidis, Rev. Inst. Adolfo Lutz, 34:119-25,1974.
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8. COLDING, H. & LUND, J. - Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis.J. din. Microbiol., 5(4): 405-9,1977.
9. COONROD, J.D.& RYTEL, M.W.-Deterrnination of aetiology of bacterial meningitis by counterim-unoelectrophoresis. Lancet, 1 (7761): 1l54-57, 1972.
10. EDWARDS, E.A. - Immunologic investigation of meningococcal disease I Group-specific Neisseria meningitidis antigens present in the serum of patients with fulminant meningococcemia. J. Immunol., 106 (2): 314-7,1971.
11. EDWARDS, E.A.; MUEHL, P.M. & PECKINPAUGHI, R.O. - Diagnosis ofbacterialmeningi-tis by counterimmunoelectrophoresis. J. Lab. clin., Med., 80(3): 449-54,1972.
12. ERICSSON, C.D.; CARMICHAEL, M.; PICKERING, L.K; MUSSET, R. & KOHL, S. -Erroneous diagnosis ofmeningitis due to false-positive Gramstainsmed.J., 71(12):1524-5, 1978.
13. EVANS-JONES, L.G. - Difficulties in diagnosing meningococcal meningitis. Brit, med. J., 1(6167):892-3, 1979.
14. FINCH, C.A. & WILKINSON, H.W. - Practical considerations in using C.LE. to identify the principal causative agents of bacterial meningitis. J. clin. Microbiol., 10(4):519-24, 1979.
15. FOSSIECK, B.J.; CRAIG, R. & PATERSON, P.Y. - Counterimmunoelectrophoresis for rapid diagnosis of meningitis due to DipZococcus pneumoniae.J. infect. Dis., 127(1):106-9, 1973.
16. FRANTZ, I.D. - Growth requirements of the meningococcus. J. Bacteriol., 43 (6): 757-61,1942.
17. GEISELER, P,J.; NELSON, K.E.; LEVIN, S.; REDDI, K.T. & MOSES, V.K. -Communityac-quired purulent meningitis: a review of 1.316 cases during the antibiotic era, 1954-1976. Rev. infect. Dis., 2(5):725-44, 1980.
18. GONZALES, A.F. - Consideraciones sobre diagnostico de Ias meningites, por análisis deI L.C.R. Rev. Sanid. Hig; publ., 45(6):659-72, 1971.
19. GREEWOOD, B.M. & WHITTLE, H.C. - Antigen-negative rneningitis due to group A Neisseria meningitidis, J. infect. Dis, 129 (2):201,1974.
20. GREENWOOD, B.M.; WHITTLE, n.c, & DOWINIC, O.R. - Countercurrent immunoelectropho-resis in the diagnosis of meningococcal infections. Lancet, 2(7723):519,1971.
21. HAGGERTY, R.J. & ZIAI, M. - Acute bacterial meningitis.Adv.Pediat., 13:129-81, 1964.
22. HYSLOP, N.E. & SWARTZ, M.N. - Bacterial meningitis. Postgrad. Med., 58(3): 120-8, 1975.
23. INGRAN, D.L.;ANDERSON,P.&SMITH,D.H.Countercurrent immunoelectrophoresis in the diagnosis of sistemic disease caused by Haemophilus influenzae type b. J. Pediat., 81:1156-59, 1972.
24. JARVIS, C.W. & SAXENA, K.M. - Does prior antibiotic treatrnent hamper the diagnosis of acute bacterial meningitis? An analysis of a series of 135 childhood cases. Clin, Pediat., 11(4):201-4, 1972.
25. JONES, R.G. - Bacterial meningitis. Part. L Incidence and diagnosis. S. Afr. medo J., 41:75-9, 1967.
26. JOYNER, R.W.; IDRISS, Z.H. & WILFERT, C.M. Misinterpretation of cerebrospinal fluid Gram stain. Pediatrics, 54(3):360, 1974.
27. La SCOLEA, L.J. Jr., & DRYJA, D. - Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance. J.clin.Microbiol., 19(2): 187 -90, 1984.
28. LENNETTE, E.H.; BALOWS, A.; HAUSHER JR., W.J. & TRUANT, J.P. -Manual ofclinicalmicrobiology. 3. ed. Washington, D.C., American Society for Microbiology, 1980. 1,044 p.
29. LEWIN, E.B. - PartialIy treated meningitis. Amer. J.Dis. Child., 128: 145-7, 1974.
30. LORIAN, V. & ATKINSON, B. - Abnorrnal forms of bacteria produced by antibiotics. Amer. J. clin, Pathol., 64(2):678-88, 1975.
31. LORIA, D.;D.; KAMINSKI,T.; GRIECCO, M. & SINGER, J. -Aberrant forms ofbacteria and fungi found in blood or cerebrospinal fluid.Arch. intem. Med., 124:39-48, 1969.
32. MANDAL, B.K. - The dilemma of partialIy treated bacterial meningitis. Scand. J. infect. Dis., 8(3):185,1976.
33. MELLES, C.E.A.; RAMIRES, M.R.N.; DINIZ, J.M.P.; ADELINO, M.G.F.; TAUNAY, A.E. & ROSSI, C.V. - Estudo comparativo de métodos diagnósticos das meningites purulentas. Rev. Inst. Med. trop. S. Paulo, 20(4): 202-7, 1978.
34. MILLAN, Y.; MENARD, M. & VANDEKERKOVE, M. - Isolement des meningocoques de sérotype A: influence de Ia durée et des conditions de conservation des liquides céphalorachidiens sur les résultats des cultures. Buli. Org. mondo Santé, 43(5): 743-9, 1970.
35. MITCHELL, M.S. - Immunofluorescent techniques for demonstrating bacterial pahogens associated with cerebrospinal meningitis II - Growth, viability and immunofluorescent staining of Haemophilus influenzae, Neisseria meningitidis and Diplococcus pneumoniae in cerebrospinal fluido
J.Lab.clin.Med., 65(6):990- 1003,1965.
36. MURRAY, E.G.D.; WEBB, R.A. & SWANN, M.B.R. - A disease of rabbits characterized by a large mononuc1ear leucocytosis, caused by a hitherto undescribed bacillus Bacterium monocytogenes (n. sp.). J. Pathol. Bacteriol., 29(4): 407- 15, 1926.
37. MUSHER, D.M. & SCHELL, R.F. - False-positive Gram stains of cerebrospinal fluido Ann. interno Med., 79(4):603-4,1973.
38. PALHARES, M.; GELLI, D.S.; ALMEIDA, M.C.R.; MELLES, C.E.A.; TAKEDA, A.K. & TAUNAY, A.E. - Pesquisa de polissacarídeos de Neisseria meningitidis do grupo C no liquido-cefalorraquidiano por imunoeletroforese cruzada em acetato de celulose. Rev. Inst. Adolfo Lutz, 33:85-9, 1973.
39. PIRES, R.B.R.; TAKEDA, A.K.; MELLES, C.E.A. & TAUNA Y, A.E. -Detecção deAgs polissacarídeos capsulares e tipagem de Streptococcus pneumoniae em LCR pela imunoeletroforese. Rev. Inst. Adolfo Lutz, 42-1982.
40. RORKE, E.M. - Valuable but neglected technique for the culture of aerobic organisms from cerebrospinal fluido J. clin. Pathol., 18:385, 1965.
41. TAKEDA, A.K.; UMEKITA, L.F.; BOSCARDIN, N.B.; MELLES, C.A.E. & TAUNAY, A.E. Imunoeletroforese cruzada no diagnóstico da meningite por Haemophilus influenzae tipo b. Rev. Inst. Adolfo Lutz, 39(2):165-9, 1979.
42. TOBIN, B.M. & JONES, D.M. - Immunoelectrophoresis in the diagnosis of meningococcal infections. J. clin. Pathol., 25:583, 1972.
43. WELLMAN, W .E. - Bacterial meningitis. Postgrad. Med., 42:7-14, 1967.
44. WENSTEIN, R.A.; BANER, F.W.; HOFFMAN, R.D.; TYLER, P.G.; ANDERSON, R.L. & STAMM, W.E. - Factitions meningitis: diagnostic error due to nonviable bacteria in commercial lumbar puncture trays. J. amer. med. Assoc.,
233(8):878-9,1975.
45. WILSON, F.M. & LERNER, A.M. - Etiology and mortality of purulent meningitis at the Detroit receiving hospital. New Engl. J. Med., 271(24): 1235-38,1964.
2. AGBAYANI, M.M.; BRAUN, J.; CHANG, C.T.; GLASS, L. & EVANS, H.E. - Effect of CSF on bacterial growth. Arch. Neurol., 38(1):43-5, 1981.
3. AMAR, R.; TOLEBEM, G.; SICRE, M.G.; LEMELAMD, J.F.; LEROY, J.& HUMBERT, G. -Les meningites puru1entes en Haute Norrnandie à propos d'une statistique hospitaliêre de 106 caso Lyon. med., 228 (18):517-25, 1972.
4. BHUSHAN, V. & CHINTU, C. - Changing pattem of pyogenic meningitis in Lusaka. East. afr, med. J., 56(11):548-56, 1979.
5. BRASIL. Ministério da Saúde. Secretaria Nacional de Ações Básicas da Saúde. Divisão Nacional de Laboratórios de Saúde Pública - Normas técnicas para o diagnóstico das meningites bacterianas. Brasília, Centro de Documentação do Ministério da Saúde, 1986.49 p. (Série A: Normas e manuais técnicos, 32).
6. CARBONARE, S.B.; TAKEDA, A.K.; JORDÃO, F.B.M. & TAUNAY, A.E. -Especificidade imunológica dos polissacarídeos extraidos de diferen-
tes grupos de Neisseria meningitidis, Rev. Inst. Adolfo Lutz, 34:119-25,1974.
7. CARPENTER, R.P. & PETERSDORF, R.G. - The c1inical spectrum of bacterial meningitis. Amer. J. Med., 33(2):262-75, 1962.
8. COLDING, H. & LUND, J. - Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis.J. din. Microbiol., 5(4): 405-9,1977.
9. COONROD, J.D.& RYTEL, M.W.-Deterrnination of aetiology of bacterial meningitis by counterim-unoelectrophoresis. Lancet, 1 (7761): 1l54-57, 1972.
10. EDWARDS, E.A. - Immunologic investigation of meningococcal disease I Group-specific Neisseria meningitidis antigens present in the serum of patients with fulminant meningococcemia. J. Immunol., 106 (2): 314-7,1971.
11. EDWARDS, E.A.; MUEHL, P.M. & PECKINPAUGHI, R.O. - Diagnosis ofbacterialmeningi-tis by counterimmunoelectrophoresis. J. Lab. clin., Med., 80(3): 449-54,1972.
12. ERICSSON, C.D.; CARMICHAEL, M.; PICKERING, L.K; MUSSET, R. & KOHL, S. -Erroneous diagnosis ofmeningitis due to false-positive Gramstainsmed.J., 71(12):1524-5, 1978.
13. EVANS-JONES, L.G. - Difficulties in diagnosing meningococcal meningitis. Brit, med. J., 1(6167):892-3, 1979.
14. FINCH, C.A. & WILKINSON, H.W. - Practical considerations in using C.LE. to identify the principal causative agents of bacterial meningitis. J. clin. Microbiol., 10(4):519-24, 1979.
15. FOSSIECK, B.J.; CRAIG, R. & PATERSON, P.Y. - Counterimmunoelectrophoresis for rapid diagnosis of meningitis due to DipZococcus pneumoniae.J. infect. Dis., 127(1):106-9, 1973.
16. FRANTZ, I.D. - Growth requirements of the meningococcus. J. Bacteriol., 43 (6): 757-61,1942.
17. GEISELER, P,J.; NELSON, K.E.; LEVIN, S.; REDDI, K.T. & MOSES, V.K. -Communityac-quired purulent meningitis: a review of 1.316 cases during the antibiotic era, 1954-1976. Rev. infect. Dis., 2(5):725-44, 1980.
18. GONZALES, A.F. - Consideraciones sobre diagnostico de Ias meningites, por análisis deI L.C.R. Rev. Sanid. Hig; publ., 45(6):659-72, 1971.
19. GREEWOOD, B.M. & WHITTLE, H.C. - Antigen-negative rneningitis due to group A Neisseria meningitidis, J. infect. Dis, 129 (2):201,1974.
20. GREENWOOD, B.M.; WHITTLE, n.c, & DOWINIC, O.R. - Countercurrent immunoelectropho-resis in the diagnosis of meningococcal infections. Lancet, 2(7723):519,1971.
21. HAGGERTY, R.J. & ZIAI, M. - Acute bacterial meningitis.Adv.Pediat., 13:129-81, 1964.
22. HYSLOP, N.E. & SWARTZ, M.N. - Bacterial meningitis. Postgrad. Med., 58(3): 120-8, 1975.
23. INGRAN, D.L.;ANDERSON,P.&SMITH,D.H.Countercurrent immunoelectrophoresis in the diagnosis of sistemic disease caused by Haemophilus influenzae type b. J. Pediat., 81:1156-59, 1972.
24. JARVIS, C.W. & SAXENA, K.M. - Does prior antibiotic treatrnent hamper the diagnosis of acute bacterial meningitis? An analysis of a series of 135 childhood cases. Clin, Pediat., 11(4):201-4, 1972.
25. JONES, R.G. - Bacterial meningitis. Part. L Incidence and diagnosis. S. Afr. medo J., 41:75-9, 1967.
26. JOYNER, R.W.; IDRISS, Z.H. & WILFERT, C.M. Misinterpretation of cerebrospinal fluid Gram stain. Pediatrics, 54(3):360, 1974.
27. La SCOLEA, L.J. Jr., & DRYJA, D. - Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance. J.clin.Microbiol., 19(2): 187 -90, 1984.
28. LENNETTE, E.H.; BALOWS, A.; HAUSHER JR., W.J. & TRUANT, J.P. -Manual ofclinicalmicrobiology. 3. ed. Washington, D.C., American Society for Microbiology, 1980. 1,044 p.
29. LEWIN, E.B. - PartialIy treated meningitis. Amer. J.Dis. Child., 128: 145-7, 1974.
30. LORIAN, V. & ATKINSON, B. - Abnorrnal forms of bacteria produced by antibiotics. Amer. J. clin, Pathol., 64(2):678-88, 1975.
31. LORIA, D.;D.; KAMINSKI,T.; GRIECCO, M. & SINGER, J. -Aberrant forms ofbacteria and fungi found in blood or cerebrospinal fluid.Arch. intem. Med., 124:39-48, 1969.
32. MANDAL, B.K. - The dilemma of partialIy treated bacterial meningitis. Scand. J. infect. Dis., 8(3):185,1976.
33. MELLES, C.E.A.; RAMIRES, M.R.N.; DINIZ, J.M.P.; ADELINO, M.G.F.; TAUNAY, A.E. & ROSSI, C.V. - Estudo comparativo de métodos diagnósticos das meningites purulentas. Rev. Inst. Med. trop. S. Paulo, 20(4): 202-7, 1978.
34. MILLAN, Y.; MENARD, M. & VANDEKERKOVE, M. - Isolement des meningocoques de sérotype A: influence de Ia durée et des conditions de conservation des liquides céphalorachidiens sur les résultats des cultures. Buli. Org. mondo Santé, 43(5): 743-9, 1970.
35. MITCHELL, M.S. - Immunofluorescent techniques for demonstrating bacterial pahogens associated with cerebrospinal meningitis II - Growth, viability and immunofluorescent staining of Haemophilus influenzae, Neisseria meningitidis and Diplococcus pneumoniae in cerebrospinal fluido
J.Lab.clin.Med., 65(6):990- 1003,1965.
36. MURRAY, E.G.D.; WEBB, R.A. & SWANN, M.B.R. - A disease of rabbits characterized by a large mononuc1ear leucocytosis, caused by a hitherto undescribed bacillus Bacterium monocytogenes (n. sp.). J. Pathol. Bacteriol., 29(4): 407- 15, 1926.
37. MUSHER, D.M. & SCHELL, R.F. - False-positive Gram stains of cerebrospinal fluido Ann. interno Med., 79(4):603-4,1973.
38. PALHARES, M.; GELLI, D.S.; ALMEIDA, M.C.R.; MELLES, C.E.A.; TAKEDA, A.K. & TAUNAY, A.E. - Pesquisa de polissacarídeos de Neisseria meningitidis do grupo C no liquido-cefalorraquidiano por imunoeletroforese cruzada em acetato de celulose. Rev. Inst. Adolfo Lutz, 33:85-9, 1973.
39. PIRES, R.B.R.; TAKEDA, A.K.; MELLES, C.E.A. & TAUNA Y, A.E. -Detecção deAgs polissacarídeos capsulares e tipagem de Streptococcus pneumoniae em LCR pela imunoeletroforese. Rev. Inst. Adolfo Lutz, 42-1982.
40. RORKE, E.M. - Valuable but neglected technique for the culture of aerobic organisms from cerebrospinal fluido J. clin. Pathol., 18:385, 1965.
41. TAKEDA, A.K.; UMEKITA, L.F.; BOSCARDIN, N.B.; MELLES, C.A.E. & TAUNAY, A.E. Imunoeletroforese cruzada no diagnóstico da meningite por Haemophilus influenzae tipo b. Rev. Inst. Adolfo Lutz, 39(2):165-9, 1979.
42. TOBIN, B.M. & JONES, D.M. - Immunoelectrophoresis in the diagnosis of meningococcal infections. J. clin. Pathol., 25:583, 1972.
43. WELLMAN, W .E. - Bacterial meningitis. Postgrad. Med., 42:7-14, 1967.
44. WENSTEIN, R.A.; BANER, F.W.; HOFFMAN, R.D.; TYLER, P.G.; ANDERSON, R.L. & STAMM, W.E. - Factitions meningitis: diagnostic error due to nonviable bacteria in commercial lumbar puncture trays. J. amer. med. Assoc.,
233(8):878-9,1975.
45. WILSON, F.M. & LERNER, A.M. - Etiology and mortality of purulent meningitis at the Detroit receiving hospital. New Engl. J. Med., 271(24): 1235-38,1964.
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Copyright (c) 1989 Instituto Adolfo Lutz Journal
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