Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1984 Feb;19(2):187–190. doi: 10.1128/jcm.19.2.187-190.1984

Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance.

L J La Scolea Jr, D Dryja
PMCID: PMC271014  PMID: 6365957

Abstract

Cerebrospinal fluid (CSF) specimens from pediatric patients with meningitis were examined for their concentration of microbes and the relationship of this count to the bacteremia levels, microscopy results, and polymorphonuclear leukocyte concentration. A total of 2,031 consecutive CSF specimens were analyzed, of which 63 (3.1%) were positive by culture from the same number of patients. We observed that 85% of the total CSF specimens positive for Haemophilus influenzae type b, Streptococcus agalactiae, Streptococcus pneumoniae, and Neisseria meningitidis had counts in excess of 10(3) CFU/ml, with 56% of the specimens exceeding 10(5) CFU/ml. A correlation existed between the number of organisms present in the CSF and blood. For example, from a total of 22 patients who had counts of H. influenzae greater than 10(3) CFU/ml in the CSF, 16 or 73% had levels of bacteremia greater than 10(3) CFU/ml. It was also noted that the bacterial concentration had a profound effect on the sensitivity of microscopy. The percentage of positive results increased from 25% with less than or equal to 10(3) CFU/ml to 60% in the range of greater than 10(3) to 10(5) CFU/ml and to 97% at concentrations of greater than 10(5) CFU/ml. Furthermore, a significant correlation (P less than 0.01) was noted between the concentration of bacteria in the CSF and the number of polymorphonuclear leukocytes observed on microscopy.

Full text

PDF
187

Selected References

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

  1. Dietzman D. E., Fischer G. W., Schoenknecht F. D. Neonatal Escherichia coli septicemia--bacterial counts in blood. J Pediatr. 1974 Jul;85(1):128–130. doi: 10.1016/s0022-3476(74)80308-2. [DOI] [PubMed] [Google Scholar]
  2. Edberg S. C. Methods of quantitative microbiological analyses that support the diagnosis, treatment, and prognosis of human infection. Crit Rev Microbiol. 1981;8(4):339–397. doi: 10.3109/10408418109085083. [DOI] [PubMed] [Google Scholar]
  3. Feldman W. E. Concentrations of bacteria in cerebrospinal fluid of patients with bacterial meningitis. J Pediatr. 1976 Apr;88(4 Pt 1):549–552. doi: 10.1016/s0022-3476(76)80003-0. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. HAGGERTY R. J., ZIAI M. ACUTE BACTERIAL MENINGITIS. Adv Pediatr. 1964;13:129–181. [PubMed] [Google Scholar]
  6. Jones S. R., Smith J. W., Sanford J. P. Localization of urinary-tract infections by detection of antibody-coated bacteria in urine sediment. N Engl J Med. 1974 Mar 14;290(11):591–593. doi: 10.1056/NEJM197403142901103. [DOI] [PubMed] [Google Scholar]
  7. KASS E. H. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56–64. [PubMed] [Google Scholar]
  8. La Scolea L. J., Jr, Dryja D., Neter E. Comparison of the quantitative direct plating method and the BACTEC procedure for rapid diagnosis of Haemophilus influenzae bacteremia in children. J Clin Microbiol. 1981 Dec;14(6):661–664. doi: 10.1128/jcm.14.6.661-664.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. La Scolea L. J., Jr, Dryja D., Sullivan T. D., Mosovich L., Ellerstein N., Neter E. Diagnosis of bacteremia in children by quantitative direct plating and a radiometric procedure. J Clin Microbiol. 1981 Mar;13(3):478–482. doi: 10.1128/jcm.13.3.478-482.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lauer B. A., Reller L. B., Mirrett S. Comparison of acridine orange and Gram stains for detection of microorganisms in cerebrospinal fluid and other clinical specimens. J Clin Microbiol. 1981 Aug;14(2):201–205. doi: 10.1128/jcm.14.2.201-205.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Sell S. H., Merrill R. E., Doyne E. O., Zimsky E. P., Jr Long-term sequelae of Hemophilus influenzae meningitis. Pediatrics. 1972 Feb;49(2):206–211. [PubMed] [Google Scholar]
  12. Sell S. H., Webb W. W., Pate J. E., Doyne E. O. Psychological sequelae to bacterial meningitis: two controlled studies. Pediatrics. 1972 Feb;49(2):212–217. [PubMed] [Google Scholar]
  13. Smith A. L., Smith D. H., Averill D. R., Jr, Marino J., Moxon E. R. Production of Haemophilus influenzae b meningitis in infant rats by intraperitoneal inoculation. Infect Immun. 1973 Aug;8(2):278–290. doi: 10.1128/iai.8.2.278-290.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sproles E. T., 3rd, Azerrad J., Williamson C., Merrill R. E. Meningitis due to Hemophilus influenzae: long-term sequelae. J Pediatr. 1969 Nov;75(5):782–788. doi: 10.1016/s0022-3476(69)80300-8. [DOI] [PubMed] [Google Scholar]
  15. Sullivan T. D., LaScolea L. J., Jr, Neter E. Relationship between the magnitude of bacteremia in children and the clinical disease. Pediatrics. 1982 Jun;69(6):699–702. [PubMed] [Google Scholar]
  16. Thomas V., Shelokov A., Forland M. Antibody-coated bacteria in the urine and the site of urinary-tract infection. N Engl J Med. 1974 Mar 14;290(11):588–590. doi: 10.1056/NEJM197403142901102. [DOI] [PubMed] [Google Scholar]
  17. Werner A. S., Cobbs C. G., Kaye D., Hook E. W. Studies on the bacteremia of bacterial endocarditis. JAMA. 1967 Oct 16;202(3):199–203. [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES