Correlation between CSF Glucose Estimation using Glucometers against the Conventional Laboratory Technique in Determining Bacterial Meningitis: An Indian Study.

Bacterial meningitis remains a disease with devastating attack rates and growing drug resistance among causative bacteria. Early diagnosis and timely management has an implication on the prognosis and outcome. However, lack of laboratory facilities, travel time for the sample to reach the laboratory and the laborious laboratory methods may result in deferment in precise treatment resulting in avoidable morbidity and mortality. Such delays can be avoided by determining CSF sugar in the emergency room using bedside glucometers, which can assist in crucial decision-making on the use of antibiotics in suspected patients. We aimed to test the accuracy of CSF glucose estimation using glucometers in detecting bacterial meningitis. This single-centred, prospective, comparative study was conducted in 50 consecutive patients suspected with CNS infections. Lumbar puncture for CSF collection was performed to test for glucose by boththe laboratory evaluation and a glucometer. Logistic regression analysis was performed to understand the relationship between culture-proven bacterial meningitis with established independent variables. The mean CSF glucose value using the conventional laboratory technique was 98.97 ± 61.10 mg/dL, and with glucometer was 109.59 ± 67.85 mg/dL. There was no significant difference (p=0.4613) among the mean glucose levels by the two methods. A statistically significant association was noted between bacterial meningitis and CSF glucose using the conventional technique (OR, 0.976; 95% CI, 0.957-0.993; p=0.0165), and CSF glucose using the glucometer (OR, 0.975; 95% CI, 0.956-0.996; p=0.0066). Bedside glucose testing from CSF fluid may be an alternative to laboratory plasma glucose measurement.