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. 1982 Sep 15;127(6):489–493.

The latex agglutination test versus counterimmunoelectrophoresis for rapid diagnosis of bacterial meningitis

Robert Bortolussi, Arthur J Wort, Stephanie Casey
PMCID: PMC1862064  PMID: 6749272

Abstract

A modified latex agglutination (LA) test was compared with Gram-staining and counterimmunoelectrophoresis (CIE) for the rapid detection in the cerebrospinal fluid (CSF) of antigen to Haemophilus influenzae type b, Neisseria meningitidis groups A, B and C, Escherichia coli K1, Streptococcus pneumoniae and group B streptococci, seven frequent causes of bacterial meningitis in children. Of 50 CSF samples from patients with culture-proven bacterial meningitis 90% were correctly shown by the LA test to contain antigen of the responsible organism. Gram-staining revealed organisms in 80% of 45 of these samples. In 75% of the 40 samples that were of sufficient volume for CIE, positive results for the appropriate antigen were obtained. The concentration of antigen detected in the CSF by the LA test varied from undetectable to 800 000 ng/ml. Patients with a high concentration (more than 2000 ng/ml or a positive result at dilutions of CSF over 1/8) were significantly more likely to have a poor response to therapy (two died and two had persistent pleocytosis or bacteria in the CSF) than patients with a lower concentration (4/16 v. 0/18, P < 0.05). After appropriate therapy was begun the concentration of antigen fell dramatically, but measurable amounts of antigen persisted in the CSF for up to 6 days. The LA test detected bacterial antigen at concentrations 2 to 70 times below the lower limit detected by CIE. In seven additional patients who had received antibiotics before lumbar puncture was performed the LA test detected antigen from meningitis-causing bacteria even though cultures of the CSF were sterile. In another 145 patients who did not have meningitis the results of the LA test were negative. The LA test, done as described in this article, is easier to perform than CIE and should be a useful addition to the diagnostic tests carried out on the CSF of any patient suspected of having meningitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brooks J. B., Kellogg D. S., Jr, Shepherd M. E., Alley C. C. Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatography: analysis of amines. J Clin Microbiol. 1980 Jan;11(1):52–58. doi: 10.1128/jcm.11.1.52-58.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Colding H., Lind I. Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis. J Clin Microbiol. 1977 Apr;5(4):405–409. doi: 10.1128/jcm.5.4.405-409.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Coonrod J. D., Rytel M. W. Determination of aetiology of bacterial meningitis by counter-immunoelectrophoresis. Lancet. 1972 May 27;1(7761):1154–1157. doi: 10.1016/s0140-6736(72)91376-1. [DOI] [PubMed] [Google Scholar]
  4. Dirks-Go S. I., Zanen H. C. Latex agglutination, counterimmunoelectrophoresis, and protein A co-agglutination in diagnosis of bacterial meningitis. J Clin Pathol. 1978 Dec;31(12):1167–1171. doi: 10.1136/jcp.31.12.1167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Drow D. L., Maki D. G., Manning D. D. Indirect sandwich enzyme-linked immunosorbent assay for rapid detection of Haemophilus influenzae type b infection. J Clin Microbiol. 1979 Oct;10(4):442–450. doi: 10.1128/jcm.10.4.442-450.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Edwards E. A., Muehl P. M., Peckinpaugh R. O. Diagnosis of bacterial meningitis by counterimmunoelectrophoresis. J Lab Clin Med. 1972 Sep;80(3):449–454. [PubMed] [Google Scholar]
  7. Edwards M. S., Kasper D. L., Baker C. J. Rapid diagnosis of type III group B streptococcal meningitis by latex particle agglutination. J Pediatr. 1979 Aug;95(2):202–205. doi: 10.1016/s0022-3476(79)80651-4. [DOI] [PubMed] [Google Scholar]
  8. Feldman W. E. Relation of concentrations of bacteria and bacterial antigen in cerebrospinal fluid to prognosis in patients with bacterial meningitis. N Engl J Med. 1977 Feb 24;296(8):433–435. doi: 10.1056/NEJM197702242960806. [DOI] [PubMed] [Google Scholar]
  9. Finch C. A., Wilkinson H. W. Practical considerations in using counterimmunoelectrophoresis to identify the principal causative agents of bacterial meningitis. J Clin Microbiol. 1979 Oct;10(4):519–524. doi: 10.1128/jcm.10.4.519-524.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Grados O., Ewing W. H. Antigenic relationship between Escherichia coli and Neisseria meningitidis. J Infect Dis. 1970 Jul-Aug;122(1):100–103. doi: 10.1093/infdis/122.1-2.100. [DOI] [PubMed] [Google Scholar]
  11. Krishnan C., Wylie J. S. Countercurrent immunoelectrophoresis (CIEP) in the diagnosis of childhood meningitis. Indian Pediatr. 1978 Sep;15(9):703–706. [PubMed] [Google Scholar]
  12. Leinonen M., Herva E. The latex agglutination test for the diagnosis of meningococcal and haemophilus influenzae meningitis. Scand J Infect Dis. 1977;9(3):187–191. doi: 10.3109/inf.1977.9.issue-3.06. [DOI] [PubMed] [Google Scholar]
  13. ORESKES I., SINGER J. M. The mechanism of particulate carrier reactions. I. Adsorption of human gamma-globulin to polystyrene latex particles. J Immunol. 1961 Mar;86:338–344. [PubMed] [Google Scholar]
  14. Pifer L., Elliott S., Woodard T., Woods D., Hughes W. T. An improved method for detection of Hemophilus influenzae b antigen in cerebrospinal fluid. J Pediatr. 1978 Feb;92(2):227–229. doi: 10.1016/s0022-3476(78)80009-2. [DOI] [PubMed] [Google Scholar]
  15. Severin W. P. Latex agglutination in the diagnosis of meningococcal meningitis. J Clin Pathol. 1972 Dec;25(12):1079–1082. doi: 10.1136/jcp.25.12.1079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Thirumoorthi M. C., Dajani A. S. Comparison of staphylococcal coagglutination, latex agglutination, and counterimmunoelectrophoresis for bacterial antigen detection. J Clin Microbiol. 1979 Jan;9(1):28–32. doi: 10.1128/jcm.9.1.28-32.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ward J. I., Siber G. R., Scheifele D. W., Smith D. H. Rapid diagnosis of Hemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis. J Pediatr. 1978 Jul;93(1):37–42. doi: 10.1016/s0022-3476(78)80596-4. [DOI] [PubMed] [Google Scholar]

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