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[化脓性脑膜炎的快速诊断]

[Rapid diagnosis of purulent meningitis].

作者信息

Husson M O, Izard D, Seynave J L, Leclerc H

出版信息

Ann Biol Clin (Paris). 1983;41(6):427-33.

PMID:6421209
Abstract

The cerebrospinal fluid of 589 subjects, 78 of whom were suffering from a purulent meningitis were examined. Comparatively by classical bacteriological techniques (direct examination and culture) and by electro-immunodiffusion, latex agglutination, and Limulus endotoxin assay. Soluble bacterial Haemophilus influenzae type B, Neisseria meningitidis group A, C, and Streptococcus pneumoniae antigens, were tested by electro-immunodiffusion and latex agglutination, and soluble bacterial N. meningitidis group B, Listeria monocytogenes and Streptococcus agalactiae antigens by electro-immunodiffusion. Specific antigens and endotoxin were found in 75.8 per cent of the specimens with a rapid answer (120 min). The three tests revealed also only the diagnosis in 29.1 per cent of cases of pneumococcal meningitis, in 33.3 per cent of meningococcal meningitis and in 47 per cent of Gram-negative bacteria meningitis. Only five cerebrospinal fluid from the 589 specimens tested were given a non-specific reaction. These two advantages--sensitivity and specificity--of these three tests render them techniques of the future in the diagnosis of purulent meningitis.

摘要

对589名受试者的脑脊液进行了检查,其中78人患有化脓性脑膜炎。采用经典细菌学技术(直接检查和培养)以及电免疫扩散、乳胶凝集和鲎试剂内毒素检测法进行比较。通过电免疫扩散和乳胶凝集检测可溶性B型流感嗜血杆菌、A、C群脑膜炎奈瑟菌和肺炎链球菌抗原,通过电免疫扩散检测可溶性B群脑膜炎奈瑟菌、单核细胞增生李斯特菌和无乳链球菌抗原。在75.8%的标本中在120分钟内快速检测到特异性抗原和内毒素。这三种检测方法在29.1%的肺炎球菌性脑膜炎病例、33.3%的脑膜炎球菌性脑膜炎病例和47%的革兰氏阴性菌性脑膜炎病例中也仅揭示了诊断结果。在检测的589份脑脊液标本中,只有5份出现非特异性反应。这三种检测方法的这两个优点——敏感性和特异性——使其成为化脓性脑膜炎诊断未来的技术。

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