RESUMO
Bacterial meningitis causes significant mortality (5-15 per cent) and considerable morbidity (30-40 per cent), and delays in diagnosis and initiation of appropriate antimicrobial therapy can be devastating. The traditional microbiological procedures of Gram stain and culture could be rendered insensitive by the prior administration of antibiotics. Latex agglutination (LA) has been found to be more sensitive in these circumstances. In this prospective study from March to October, 1988, 193 CSF samples were evaluated by Gram stain, culture (horse blood agar at 37§C, supplemented chocolate agar, 37§C and 5 per cent CO2 and Levinthal broth), standard biochemical analysis and LA (Directigen Meningitis Combo test kit, Becton Dickenson Microbiology Systems). The medical records of the 193 patients were reviewed and 29 were diagnosed as having bacterial meningitis based on the history, signs, symptoms and CSF findings. The sensitivities of the LA, Gram stain and culture were 90 per cent, 42 per cent and 43 per cent respectively. The LA was far superior in sensitivity to Gram stain and culture and in this study identified 13 cases that were missed by Gram stain and culture. The LA test could be a valuable adjunct to the latter 2 tests in the aetiological diagnosis of bacterial meningitis (AU)
