Deivanayagam N, Ashok T P, Nedunchelian K, Ahamed S S, Mala N
Clinical Epidemiology Unit, Madras Medical College.
Indian Pediatr. 1993 Apr;30(4):495-500.
To know the usefulness of Latex Agglutination Test (LAT) for the diagnosis of bacterial meningitis (BM), it was performed in all the 114 consecutive samples of CSF with polymorphs from 114 prospectively recruited children aged 2 months to 11 years. Definite diagnosis of BM based on culture and/or LAT was evident in 55. Among the 46 LAT positive, culture was positive in 3 only. Major organisms identified by LAT were H. influenzae B (HiB) in 28 and S. pneumoniae (SP) in 15. Ninety per cent of HiB and 67% of SP bacterial meningitis were under one year of age. Fever > 7 days prior to admission was not uncommon (38%) and 26% had received prior antibiotics. Meningeal signs were present in 64%. CSF cells were < 500/mm3 in 24% and sugar was > 50% of blood level in 23%. There was no significant difference in the immediate outcome between HiB and SP meningitis. The case fatality was 22% and was significantly high in cases who had altered level of consciousness on admission (p = 0.02). It is concluded that LAT is very useful for rapid diagnosis of BM.
为了解乳胶凝集试验（LAT）在细菌性脑膜炎（BM）诊断中的作用，对114例前瞻性招募的年龄在2个月至11岁的儿童连续采集的114份脑脊液多形核细胞样本进行了该试验。基于培养和/或LAT确诊的BM有55例。在46例LAT阳性病例中，只有3例培养呈阳性。LAT鉴定出的主要病原体为28例B型流感嗜血杆菌（HiB）和15例肺炎链球菌（SP）。90%的HiB和67%的SP细菌性脑膜炎发生在1岁以下儿童。入院前发热超过7天并不少见（38%），26%的患儿曾接受过抗生素治疗。64%的患儿有脑膜刺激征。24%的患儿脑脊液细胞数<500/mm3，23%的患儿脑脊液糖含量>血糖水平的50%。HiB和SP脑膜炎的近期转归无显著差异。病死率为22%，入院时意识水平改变的患儿病死率显著较高（p = 0.02）。结论是LAT对BM的快速诊断非常有用。
