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Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children

OBJECTIVE: To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. METHODS: A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary...

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Autores principales: Pires, Frederico Ribeiro, Franco, Andréia Christine Bonotto Farias, Gilio, Alfredo Elias, Troster, Eduardo Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609612/
https://www.ncbi.nlm.nih.gov/pubmed/28767914
http://dx.doi.org/10.1590/S1679-45082017AO3880
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author Pires, Frederico Ribeiro
Franco, Andréia Christine Bonotto Farias
Gilio, Alfredo Elias
Troster, Eduardo Juan
author_facet Pires, Frederico Ribeiro
Franco, Andréia Christine Bonotto Farias
Gilio, Alfredo Elias
Troster, Eduardo Juan
author_sort Pires, Frederico Ribeiro
collection PubMed
description OBJECTIVE: To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. METHODS: A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. RESULTS: The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. CONCLUSION: Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone.
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spelling pubmed-56096122017-09-27 Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children Pires, Frederico Ribeiro Franco, Andréia Christine Bonotto Farias Gilio, Alfredo Elias Troster, Eduardo Juan Einstein (Sao Paulo) Original Article OBJECTIVE: To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. METHODS: A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture. RESULTS: The study included 503 patients. Sixty-four patients were excluded and 94 were not submitted to all tests for analysis. Of the remaining 345 patients, 7 were in the Bacterial Meningitis Group and 338 in the Aseptic Meningitis Group. There was no statistical difference between the groups. In the Bacterial Meningitis Score analysis, of the 338 patients with possible aseptic meningitis (negative cultures), 121 of them had one or more points in the Bacterial Meningitis Score, with sensitivity of 100%, specificity of 64.2%, and negative predictive value of 100%. Of the 121 patients with positive Bacterial Meningitis Score, 71% (86 patients) had a positive enterovirus detection in cerebrospinal fluid. CONCLUSION: Enterovirus detection in cerebrospinal fluid was effective to differentiate bacterial from viral meningitis. When the test was analyzed together with the Bacterial Meningitis Score, specificity was higher when compared to Bacterial Meningitis Score alone. Instituto Israelita de Ensino e Pesquisa Albert Einstein 2017 /pmc/articles/PMC5609612/ /pubmed/28767914 http://dx.doi.org/10.1590/S1679-45082017AO3880 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Pires, Frederico Ribeiro
Franco, Andréia Christine Bonotto Farias
Gilio, Alfredo Elias
Troster, Eduardo Juan
Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title_full Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title_fullStr Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title_full_unstemmed Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title_short Comparison of enterovirus detection in cerebrospinal fluid with Bacterial Meningitis Score in children
title_sort comparison of enterovirus detection in cerebrospinal fluid with bacterial meningitis score in children
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609612/
https://www.ncbi.nlm.nih.gov/pubmed/28767914
http://dx.doi.org/10.1590/S1679-45082017AO3880
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