Shokouhi Shervin, Karamipour Mehdi, Darazam Ilad Alavi, Sepehrvand Nariman, Ahmadi Hasanali, Sajadi Mohammad M
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Infect Disord Drug Targets. 2018;18(1):29-34. doi: 10.2174/1871526517666170317112233.
Rapid and accurate diagnosis of patients with suspected bacterial meningitis (BM) is crucial to prevent potential subsequent mortality and morbidity. The aim of this study was to explore the diagnostic value of the rapid leukocyte esterase (LE) strip test in identifying pleocytosis in cerebrospinal fluid (CSF) samples of patients with suspected BM.
A total of 126 patients with suspected meningitis were enrolled in this prospective study. Microscopic examination (cell count and differential) and leukocyte esterase (LE) rapid strip test were performed on cerebrospinal fluid (CSF) samples. Sensitivity, specificity, positive predictive value and negative predictive value of the LE test were determined.
Fifty-two patients (41%) had pleocytosis in the CSF, while 48 (38%) patients had a positive rapid LE strip test result. The diagnostic accuracy of this test for pleocytosis was translated to a sensitivity of 84.6% (95%CI 71.9, 93.1) and a specificity of 94.5% (95%CI 86.7, 98.5), with an area under the receiver operating curve of 0.88.
The LE strip test, through rapid and accurate determination of CSF pleocytosis, could be considered as an additional test in the diagnosis of bacterial meningitis. It can be tested at bedside and is feasible to do in resource-limited settings.
对疑似细菌性脑膜炎（BM）患者进行快速准确的诊断对于预防潜在的后续死亡率和发病率至关重要。本研究的目的是探讨快速白细胞酯酶（LE）试纸条检测在识别疑似BM患者脑脊液（CSF）样本中细胞增多症方面的诊断价值。
本前瞻性研究共纳入126例疑似脑膜炎患者。对脑脊液（CSF）样本进行显微镜检查（细胞计数和分类）和白细胞酯酶（LE）快速试纸条检测。确定LE检测的敏感性、特异性、阳性预测值和阴性预测值。
52例（41%）患者脑脊液中存在细胞增多症，而48例（38%）患者LE快速试纸条检测结果为阳性。该检测对细胞增多症的诊断准确性转化为敏感性为84.6%（95%CI 71.9，93.1），特异性为94.5%（95%CI 86.7，98.5），受试者操作特征曲线下面积为0.88。
LE试纸条检测通过快速准确地测定脑脊液细胞增多症，可被视为细菌性脑膜炎诊断中的一项辅助检测。它可以在床边进行检测，并且在资源有限的环境中也可行。
