Incidence of bacterial meningitis in Asia using enhanced CSF testing: polymerase chain reaction, latex agglutination and culture
Open accessAbstract
To enhance the detection of bacterial meningitis in an East Asian surveillance study, we employed cerebrospinal fluid (CSF) bacterial culture, latex agglutination (LA) and polymerase chain reaction-enzyme immunoassay (PCR-EIA) testing for Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). The sensitivity and specificity of CSF PCR-EIA testing was compared to LA and culture. A meningitis case was defined by one positive result for any of the three tests. The sensitivity of H. influenzae CSF PCR-EIA, LA, and culture was 100%, 40% and 57.5% respectively; and for Sp CSF PCR-EIA, LA and culture, the sensitivity was 100%, 58.3% and 66.7%, respectively. Hib and Sp specificity was 100% by each method. CSF PCR-EIA was more sensitive than culture or LA for the detection of Hib and Sp meningitis cases increasing their incidence by 74% and 50% compared to culture respectively. CSF PCR-EIA should be included for the detection of bacterial meningitis in surveillance studies.
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The sensitivity of bexA PCR for Haemophilus influenzae ranged from 81% to 100% with a median of 93%, and specificity ranged from 81% to 100% with a median of 94%.
“The sensitivity of bexA PCR ranged from 81% to 100% with a median of 93%, with a specificity ranging from 81% to 100% (median 94%) (54, 58, 65–68).”
From Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections (2024) · cites this paper as [54]
The Nucleic acid amplification detection assays section identifies the H. influenzae test as using bexA primers. The Comparison of culture with LA and PCR-EIA assays section (page unavailable) reports 100% sensitivity and 100% specificity for that test, supporting the upper endpoints of the cited ranges. It does not report the 81% lower endpoints or the 93% and 94% medians across studies. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe reported sensitivity of PCR for pneumococcal meningitis is high and reached 100% in the majority of studies, with a median of 100% and range 79%-100%.
“The reported sensitivity of PCR for pneumococcal meningitis is high and reached 100% in the majority of conducted studies (median of 100%, range 79%–100%) (Table 1; see also Table S1 in the supplemental material) (49–58).”
From Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections (2024) · cites this paper as [54]
The Abstract reports 100% sensitivity for pneumococcal (Sp) CSF PCR-EIA in this study, supporting its inclusion among studies reporting high sensitivity. This paper does not establish that a majority of studies reached 100%, or the stated median and 79%–100% range across studies. (LLM, conf=0.85)
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“(54, 58, 65–68).”
- Authors
- KENNEDY, W. A., CHANG, S.-J., PURDY, K., LE, T., KILGORE, P. E., KIM, J. S., ANH, D. D., HUONG, P. L. T., DONG, B. Q., TAN, D. M., CLEMENS, J. D., & WARD, J. I.
- Affiliations
- University of California, Los Angeles (US)
- International Vaccine Institute (KR)
- National Institute Of Hygiene And Epidemiology (VN)
- Guangxi Center for Disease Prevention and Control (CN)
- Corresponding author
- KENNEDY, W. A.
- Venue
- Epidemiology and Infection
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-02-05
- Volume
- 135
- Issue
- 7
- Pages
- 1217-1226
- ISSN
- 0950-2688 (ISSN-L)
- 1469-4409
- PMC
- PMC2870670
- OpenAlex
- W2099033918
- Cited by
- 66
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 6 · 2012: 3
- FWCI
- 3.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Infection (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- GlaxoSmithKline
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- bacterial meningitis, latex agglutination test, cerebrospinal fluid culture, Haemophilus influenzae type b, Streptococcus pneumoniae, sensitivity and specificity, meningitis surveillance, incidence estimation, East Asia
- MeSH terms
- Asia, Bacteriological Techniques, Cerebrospinal Fluid, Child, Preschool, Female, Humans, Infant, Latex Fixation Tests, Male, Meningitis, Haemophilus, Meningitis, Pneumococcal, Sensitivity and Specificity, Streptococcus pneumoniae, Colony Count, Microbial, Incidence, Polymerase Chain Reaction, Haemophilus influenzae type b
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