Bhisitkul D M, Hogan A E, Tanz R R
Department of Pediatrics, Northwestern University Medical School, Children's Memorial Hospital, Chicago.
Pediatr Emerg Care. 1994 Apr;10(2):67-71. doi: 10.1097/00006565-199404000-00001.
We sought to determine the circumstances under which cerebrospinal fluid (CSF) bacterial antigen detection tests. (BADT) are indicated. The medical records of 146 consecutive patients with bacterial meningitis seen from 1986 to 1991 were reviewed retrospectively (mean age 16 months; median eight months). Bacterial meningitis was defined as a positive CSF culture or a positive CSF BADT, in association with the clinical presentation and response to antibiotic treatment consistent with bacterial meningitis. Before lumbar puncture, 61/146 (42%) of meningitis patients had received treatment with antibiotics. CSF BADT was performed on 56/61 (92%) of pretreated patients; of these, 48 (87%) were positive, and 8 (13%) were negative. In this group, 15/61 (25%) of pretreated patients had a negative CSF culture but a positive CSF BADT. All 85 patients who did not receive antibiotics before lumbar puncture had positive CSF cultures and 52/75 (69%) had positive CSF BADT. Because prior antibiotic therapy may impair bacterial growth from the CSF, a CSF BADT should be performed whenever the patient has received prior antibiotic treatment.
我们试图确定脑脊液（CSF）细菌抗原检测试验（BADT）适用的情况。回顾性分析了1986年至1991年期间连续收治的146例细菌性脑膜炎患者的病历（平均年龄16个月；中位数8个月）。细菌性脑膜炎的定义为脑脊液培养阳性或脑脊液BADT阳性，同时伴有符合细菌性脑膜炎的临床表现及对抗生素治疗的反应。在腰椎穿刺前，61/146（42%）的脑膜炎患者接受了抗生素治疗。对56/61（92%）接受过治疗的患者进行了脑脊液BADT检测；其中，48例（87%）呈阳性，8例（13%）呈阴性。在该组中，15/61（25%）接受过治疗的患者脑脊液培养阴性但脑脊液BADT阳性。所有85例在腰椎穿刺前未接受抗生素治疗的患者脑脊液培养均为阳性，52/75（69%）脑脊液BADT阳性。由于先前的抗生素治疗可能会抑制脑脊液中的细菌生长，因此只要患者接受过先前的抗生素治疗，就应进行脑脊液BADT检测。
