Chadalavada Bhavya, Baddam Ritesh R, Rao Raja M
Junior Resident, Department of General Medicine, Gandhi Medical College, Secunderabad, Telangana, India, Corresponding Author.
Junior Resident, Department of General Medicine, Gandhi Medical College, Secunderabad, Telangana, India.
J Assoc Physicians India. 2025 Apr;73(4):22-26. doi: 10.59556/japi.73.0890.
Meningitis is an inflammatory disease of the leptomeninges and is defined by the abnormal number of white blood cells (WBCs) in the cerebrospinal fluid (CSF). Meningitis-related mortality and morbidity can be decreased with early diagnosis and antibiotic administration. The most reliable method of diagnosis is still CSF analysis. Yet, a straightforward bedside test would be helpful for early identification due to the absence of experienced staff, laboratory, and transport services at the primary health care level in developing countries.
Patients fitting the inclusion criteria were admitted to Gandhi Hospital, and a lumbar puncture was performed under aseptic conditions. Using the SEIMENS Multistix 10 SG reagent strip as the index test and CSF microscopy and biochemistry as the gold standard diagnostic test, CSF was examined for proteins, sugars, and leukocytes.
Among 100 CSF specimens evaluated, 52 (52%) were normal and 48 (48%) were considered as having pleocytosis. The overall performance of the urine leukocyte strip when compared to CSF leukocytes had a sensitivity of 95.8%, specificity of 67.3%, negative predictive value (NPV) of 94.6%, and positive predictive value (PPV) of 73.1%. The protein portion of the urine strip was compared to quantitative CSF proteins and showed a sensitivity of 90%, specificity of 70%, PPV of 66.7%, NPV of 91.3%, and diagnostic accuracy of 78%. The glucose portion of the reagent strip also performed better than the standard test, with a sensitivity of 100%, specificity of 93.8%, PPV of 90%, NPV of 100%, and diagnostic accuracy of 96%. For the diagnosis of bacterial meningitis, the strip glucose showed a sensitivity of 100%, specificity of 69.7%, PPV of 35%, NPV of 100%, and diagnostic accuracy of 74%. The significance of the reagent strip test for leukocytes, proteins, and sugars, when compared to the standard test, was established at a 95% confidence interval (CI) using the Pearson Chi-squared test.
The urinary reagent strip is a simple test for a semiquantitative assessment of CSF, which may help with the diagnosis of meningitis at the point of care. It can also assist in deciding whether to begin antimicrobial therapy in settings with limited resources.
脑膜炎是软脑膜的一种炎症性疾病，由脑脊液（CSF）中白细胞（WBC）数量异常来定义。早期诊断并给予抗生素治疗可降低脑膜炎相关的死亡率和发病率。最可靠的诊断方法仍是脑脊液分析。然而，在发展中国家的初级卫生保健层面，由于缺乏经验丰富的工作人员、实验室和转运服务，一种简单的床旁检测方法将有助于早期识别。
符合纳入标准的患者入住甘地医院，在无菌条件下进行腰椎穿刺。以西门子Multistix 10 SG试剂条作为指标检测，脑脊液显微镜检查和生化检查作为金标准诊断检测，对脑脊液进行蛋白质、糖和白细胞检测。
在评估的100份脑脊液标本中，52份（52%）正常，48份（48%）被认为有细胞增多。与脑脊液白细胞相比，尿白细胞试纸条的总体性能为敏感性95.8%、特异性67.3%、阴性预测值（NPV）94.6%、阳性预测值（PPV）73.1%。将尿试纸条的蛋白质部分与脑脊液定量蛋白质进行比较，其敏感性为90%、特异性70%、PPV 66.7%、NPV 91.3%、诊断准确性78%。试剂条的葡萄糖部分表现也优于标准检测，敏感性为100%、特异性93.8%、PPV 90%、NPV 100%、诊断准确性96%。对于细菌性脑膜炎的诊断，试纸条葡萄糖的敏感性为100%、特异性69.7%、PPV 35%、NPV 100%、诊断准确性74%。使用Pearson卡方检验在95%置信区间（CI）确定了与标准检测相比，试剂条检测白细胞、蛋白质和糖的意义。
尿试剂条是一种用于脑脊液半定量评估的简单检测方法，可能有助于在护理点诊断脑膜炎。它还可协助在资源有限的情况下决定是否开始抗菌治疗。
